Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)

• Published in: Annals of oncology Vol. 24; no. 9; pp. 2245 - 2255
• Main Authors: Kamper-Jørgensen, M., Rostgaard, K., Glaser, S.L., Zahm, S.H., Cozen, W., Smedby, K.E., Sanjosé, S., Chang, E.T., Zheng, T., La Vecchia, C., Serraino, D., Monnereau, A., Kane, E.V., Miligi, L., Vineis, P., Spinelli, J.J., McLaughlin, J.R., Pahwa, P., Dosman, J.A., Vornanen, M., Foretova, L., Maynadie, M., Becker, N., Nieters, A., Brennan, P., Boffetta, P., Cocco, P., Hjalgrim, H., Staines, A.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2013; Oxford University Press; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Biological and medical sciences; Case-Control Studies; case–control; cigarette smoking; epidemiology; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - epidemiology; Epstein–Barr virus; Female; Hematologic and hematopoietic diseases; Herpesvirus 4, Human - isolation & purification; Hodgkin Disease - chemically induced; Hodgkin Disease - epidemiology; Hodgkin lymphoma; Humans; individual patient data meta-analysis; Infectious diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Life Sciences; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Pharmacology. Drug treatments; Reviews; Risk; Risk Factors; Santé publique et épidémiologie; Smoking - adverse effects; Smoking - epidemiology; Social Class; Tobacco Use Disorder - complications; Tobacco Use Disorder - epidemiology; Tobacco, tobacco smoking; Toxicology; Viral diseases; Young Adult; cigarette smoking; epidemiology; individual patient data meta-analysis; case–control; Epstein–Barr virus; Hodgkin lymphoma; Tobacco smoking; Epstein Barr virus; Case control study; Epstein―Barr virus; Epidemiology; Metaanalysis; Cigarette; Lymphoproliferative syndrome; Public health; International; Gammaherpesvirinae; Human; Data analysis; Herpesviridae; Hodgkin disease; Malignant hemopathy; Lymphoid neoplasm; Lymphoma; Infection; Virus; Viral disease; Risk factor; case―control; Subtype; Cancer
• ISSN: 0923-7534; 1569-8041; 1569-8041
• DOI: 10.1093/annonc/mdt218

The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes. Through the InterLymph Consortium, 12 case–control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology and Epstein–Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls. Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01–1.21]. This increased risk reflected associations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29–1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27–2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90–1.32) and EBV-negative HL (OR = 1.02, 95% CI 0.72–1.44) was not increased. These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking should be added to the few modifiable HL risk factors identified.