Associations between anthropometric, lifestyle, and dietary risk factors and non-Hodgkin lymphoma, by lymphoma subtype
| Exposure . | Controls,N† . | All NHL combined* . | DLBCL . | Follicular lymphoma . | Marginal zone lymphoma . | CLL/SLL . | P homo-geneity . | Lowest P value from pairwise analysis§ . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | ||||
| BMI, kg/m2 | |||||||||||||
| < 25 | 305 | 398 | 1.0 (reference) | 117 | 1.0 (reference) | 104 | 1.0 (reference) | 29 | 1.0 (reference) | 50 | 1.0 (reference) | ||
| 25-< 35 | 578 | 688 | 0.9 (0.8, 1.1) | 215 | 1.0 (0.7, 1.3) | 161 | 0.9 (0.6, 1.1) | 60 | 1.1 (0.7, 1.8) | 66 | 0.6 (0.4, 0.9) | ||
| 35+ | 94 | 132 | 1.1 (0.8, 1.5) | 57 | 1.7 (1.1, 2.5) | 23 | 0.7 (0.4, 1.2) | 9 | 1.0 (0.5, 2.3) | 12 | 0.7 (0.4, 1.4) | ||
| P trend | .4 | .06 | .2 | .8 | .06 | .008 | DLBCL vs FL, MZ, CLL/SLL; P = .01 | ||||||
| Height, in | |||||||||||||
| < 65 | 283 | 308 | 1.0 (reference) | 93 | 1.0 (reference) | 71 | 1.0 (reference) | 29 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 65-70 | 472 | 602 | 1.2 (0.9, 1.5) | 186 | 1.1 (0.8, 1.6) | 142 | 1.4 (1.0, 2.0) | 50 | 1.2 (0.7, 2.1) | 69 | 1.3 (0.7, 2.2) | ||
| 71+ | 232 | 319 | 1.3 (0.9, 1.8) | 112 | 1.3 (0.8, 2.1) | 76 | 1.8 (1.1, 2.9) | 19 | 1.1 (0.5, 2.4) | 33 | 1.1 (0.6, 2.3) | ||
| P trend | .3 | .2 | .02 | .8 | .9 | .5 | DLBCL, FL vs MZ, CLL/SLL; P = .04 | ||||||
| Cigarette smoking‖ | |||||||||||||
| Never | 184 | 219 | 1.0 (reference) | 83 | 1.0 (reference) | 56 | 1.0 (reference) | 15 | 1.0 (reference) | 23 | 1.0 (reference) | ||
| Former | 161 | 161 | 0.9 (0.6, 1.2) | 54 | 0.8 (0.5, 1.2) | 37 | 0.9 (0.5, 1.4) | 10 | 0.8 (0.3, 1.9) | 18 | 0.8 (0.4, 1.6) | ||
| Current | 61 | 89 | 1.1 (0.7, 1.6) | 29 | 1.0 (0.6, 1.6) | 24 | 1.1 (0.6, 2.1) | 6 | 1.1 (0.4, 3.0) | 9 | 1.1 (0.5, 2.6) | .9 | DLBCL, MZ vs FL, CLL/SLL; P = .5 |
| Ethanol | |||||||||||||
| Nondrinkers | 156 | 236 | 1.0 (reference) | 83 | 1.0 (reference) | 65 | 1.0 (reference) | 15 | 1.0 (reference) | 24 | 1.0 (reference) | ||
| Ever drinkers | 233 | 228 | 0.6 (0.4, 0.7) | 83 | 0.6 (0.4, 0.8) | 52 | 0.5 (0.3, 0.7) | 16 | 0.6 (0.3, 1.4) | 24 | 0.6 (0.3, 1.2) | .8 | DLBCL, FL vs MZ, CLL/SLL; P = .002 |
| Dietary vitamin B6, mg/1000 kcal | |||||||||||||
| < 0.97 | 197 | 286 | 1.0 (reference) | 110 | 1.0 (reference) | 68 | 1.0 (reference) | 17 | 1.0 (reference) | 32 | 1.0 (reference) | ||
| 0.97+ | 192 | 178 | 0.7 (0.5, 0.9) | 56 | 0.6 (0.4, 0.8) | 49 | 0.8 (0.5, 1.3) | 14 | 1.1 (0.5, 2.3) | 16 | 0.5 (0.3, 1.0) | .2 | DLBCL, CLL/SLL vs FL, MZ; P = .002 |
| Dietary lutein and zeaxanthin, μg/d | |||||||||||||
| < 1915 | 195 | 274 | 1.0 (reference) | 99 | 1.0 (reference) | 70 | 1.0 (reference) | 20 | 1.0 (reference) | 31 | 1.0 (reference) | ||
| 1915+ | 194 | 190 | 0.8 (0.6, 1.1) | 67 | 0.8 (0.5, 1.2) | 47 | 0.8 (0.5, 1.3) | 11 | 0.6 (0.3, 1.3) | 17 | 0.6 (0.3, 1.2) | .8 | CLL/SLL vs DLBCL, FL, MZ; P = .2 |
| Dietary zinc, mg/d | |||||||||||||
| < 16 | 196 | 269 | 1.0 (reference) | 96 | 1.0 (reference) | 67 | 1.0 (reference) | 16 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 16+ | 193 | 195 | 0.8 (0.6, 1.0) | 70 | 0.8 (0.5, 1.1) | 50 | 0.8 (0.5, 1.2) | 15 | 1.1 (0.5, 2.3) | 19 | 0.6 (0.3, 1.1) | .7 | DLBCL, CLL/SLL vs FL, MZ; P = .1 |
| Green leafy vegetables, servings/wk | |||||||||||||
| < 4 | 195 | 297 | 1.0 (reference) | 116 | 1.0 (reference) | 74 | 1.0 (reference) | 21 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 4+ | 194 | 167 | 0.6 (0.5, 0.8) | 50 | 0.5 (0.3, 0.7) | 43 | 0.6 (0.4, 1.0) | 10 | 0.4 (0.2, 1.0) | 19 | 0.8 (0.4, 1.5) | .5 | DLBCL, MZ vs FL, CLL/SLL; P < .001 |
| Cruciferous vegetables, servings/wk | |||||||||||||
| < 2 | 196 | 269 | 1.0 (reference) | 96 | 1.0 (reference) | 66 | 1.0 (reference) | 20 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 2+ | 193 | 195 | 0.8 (0.6, 1.1) | 70 | 0.8 (0.6, 1.2) | 51 | 0.9 (0.6, 1.3) | 11 | 0.6 (0.3, 1.4) | 19 | 0.8 (0.4, 1.4) | .9 | MZ vs DLBCL, FL, CLL/SLL; P = .4 |
| Dietary MeIQx, ng/d | |||||||||||||
| < 33.4 | 235 | 262 | 1.0 (reference) | 86 | 1.0 (reference) | 77 | 1.0 (reference) | 20 | 1.0 (reference) | 15 | 1.0 (reference) | ||
| 33.4+ | 154 | 202 | 1.0 (0.8, 1.4) | 80 | 1.2 (0.8, 1.8) | 40 | 0.7 (0.4, 1.1) | 11 | 0.8 (0.3, 1.7) | 33 | 3.0 (1.5, 5.9) | < .001 | CLL/SLL vs DLBCL, FL, MZ; P < .001 |
| Dietary PhIP, ng/d | |||||||||||||
| < 105.6 | 234 | 279 | 1.0 (reference) | 102 | 1.0 (reference) | 74 | 1.0 (reference) | 18 | 1.0 (reference) | 25 | 1.0 (reference) | ||
| 105.6+ | 155 | 185 | 0.8 (0.6, 1.1) | 64 | 0.7 (0.5, 1.1) | 43 | 0.7 (0.4, 1.1) | 13 | 0.9 (0.4, 2.0) | 23 | 1.2 (0.6, 2.3) | .4 | DLBCL, FL vs MZ, CLL/SLL; P = .03 |
| Exposure . | Controls,N† . | All NHL combined* . | DLBCL . | Follicular lymphoma . | Marginal zone lymphoma . | CLL/SLL . | P homo-geneity . | Lowest P value from pairwise analysis§ . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | ||||
| BMI, kg/m2 | |||||||||||||
| < 25 | 305 | 398 | 1.0 (reference) | 117 | 1.0 (reference) | 104 | 1.0 (reference) | 29 | 1.0 (reference) | 50 | 1.0 (reference) | ||
| 25-< 35 | 578 | 688 | 0.9 (0.8, 1.1) | 215 | 1.0 (0.7, 1.3) | 161 | 0.9 (0.6, 1.1) | 60 | 1.1 (0.7, 1.8) | 66 | 0.6 (0.4, 0.9) | ||
| 35+ | 94 | 132 | 1.1 (0.8, 1.5) | 57 | 1.7 (1.1, 2.5) | 23 | 0.7 (0.4, 1.2) | 9 | 1.0 (0.5, 2.3) | 12 | 0.7 (0.4, 1.4) | ||
| P trend | .4 | .06 | .2 | .8 | .06 | .008 | DLBCL vs FL, MZ, CLL/SLL; P = .01 | ||||||
| Height, in | |||||||||||||
| < 65 | 283 | 308 | 1.0 (reference) | 93 | 1.0 (reference) | 71 | 1.0 (reference) | 29 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 65-70 | 472 | 602 | 1.2 (0.9, 1.5) | 186 | 1.1 (0.8, 1.6) | 142 | 1.4 (1.0, 2.0) | 50 | 1.2 (0.7, 2.1) | 69 | 1.3 (0.7, 2.2) | ||
| 71+ | 232 | 319 | 1.3 (0.9, 1.8) | 112 | 1.3 (0.8, 2.1) | 76 | 1.8 (1.1, 2.9) | 19 | 1.1 (0.5, 2.4) | 33 | 1.1 (0.6, 2.3) | ||
| P trend | .3 | .2 | .02 | .8 | .9 | .5 | DLBCL, FL vs MZ, CLL/SLL; P = .04 | ||||||
| Cigarette smoking‖ | |||||||||||||
| Never | 184 | 219 | 1.0 (reference) | 83 | 1.0 (reference) | 56 | 1.0 (reference) | 15 | 1.0 (reference) | 23 | 1.0 (reference) | ||
| Former | 161 | 161 | 0.9 (0.6, 1.2) | 54 | 0.8 (0.5, 1.2) | 37 | 0.9 (0.5, 1.4) | 10 | 0.8 (0.3, 1.9) | 18 | 0.8 (0.4, 1.6) | ||
| Current | 61 | 89 | 1.1 (0.7, 1.6) | 29 | 1.0 (0.6, 1.6) | 24 | 1.1 (0.6, 2.1) | 6 | 1.1 (0.4, 3.0) | 9 | 1.1 (0.5, 2.6) | .9 | DLBCL, MZ vs FL, CLL/SLL; P = .5 |
| Ethanol | |||||||||||||
| Nondrinkers | 156 | 236 | 1.0 (reference) | 83 | 1.0 (reference) | 65 | 1.0 (reference) | 15 | 1.0 (reference) | 24 | 1.0 (reference) | ||
| Ever drinkers | 233 | 228 | 0.6 (0.4, 0.7) | 83 | 0.6 (0.4, 0.8) | 52 | 0.5 (0.3, 0.7) | 16 | 0.6 (0.3, 1.4) | 24 | 0.6 (0.3, 1.2) | .8 | DLBCL, FL vs MZ, CLL/SLL; P = .002 |
| Dietary vitamin B6, mg/1000 kcal | |||||||||||||
| < 0.97 | 197 | 286 | 1.0 (reference) | 110 | 1.0 (reference) | 68 | 1.0 (reference) | 17 | 1.0 (reference) | 32 | 1.0 (reference) | ||
| 0.97+ | 192 | 178 | 0.7 (0.5, 0.9) | 56 | 0.6 (0.4, 0.8) | 49 | 0.8 (0.5, 1.3) | 14 | 1.1 (0.5, 2.3) | 16 | 0.5 (0.3, 1.0) | .2 | DLBCL, CLL/SLL vs FL, MZ; P = .002 |
| Dietary lutein and zeaxanthin, μg/d | |||||||||||||
| < 1915 | 195 | 274 | 1.0 (reference) | 99 | 1.0 (reference) | 70 | 1.0 (reference) | 20 | 1.0 (reference) | 31 | 1.0 (reference) | ||
| 1915+ | 194 | 190 | 0.8 (0.6, 1.1) | 67 | 0.8 (0.5, 1.2) | 47 | 0.8 (0.5, 1.3) | 11 | 0.6 (0.3, 1.3) | 17 | 0.6 (0.3, 1.2) | .8 | CLL/SLL vs DLBCL, FL, MZ; P = .2 |
| Dietary zinc, mg/d | |||||||||||||
| < 16 | 196 | 269 | 1.0 (reference) | 96 | 1.0 (reference) | 67 | 1.0 (reference) | 16 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 16+ | 193 | 195 | 0.8 (0.6, 1.0) | 70 | 0.8 (0.5, 1.1) | 50 | 0.8 (0.5, 1.2) | 15 | 1.1 (0.5, 2.3) | 19 | 0.6 (0.3, 1.1) | .7 | DLBCL, CLL/SLL vs FL, MZ; P = .1 |
| Green leafy vegetables, servings/wk | |||||||||||||
| < 4 | 195 | 297 | 1.0 (reference) | 116 | 1.0 (reference) | 74 | 1.0 (reference) | 21 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 4+ | 194 | 167 | 0.6 (0.5, 0.8) | 50 | 0.5 (0.3, 0.7) | 43 | 0.6 (0.4, 1.0) | 10 | 0.4 (0.2, 1.0) | 19 | 0.8 (0.4, 1.5) | .5 | DLBCL, MZ vs FL, CLL/SLL; P < .001 |
| Cruciferous vegetables, servings/wk | |||||||||||||
| < 2 | 196 | 269 | 1.0 (reference) | 96 | 1.0 (reference) | 66 | 1.0 (reference) | 20 | 1.0 (reference) | 29 | 1.0 (reference) | ||
| 2+ | 193 | 195 | 0.8 (0.6, 1.1) | 70 | 0.8 (0.6, 1.2) | 51 | 0.9 (0.6, 1.3) | 11 | 0.6 (0.3, 1.4) | 19 | 0.8 (0.4, 1.4) | .9 | MZ vs DLBCL, FL, CLL/SLL; P = .4 |
| Dietary MeIQx, ng/d | |||||||||||||
| < 33.4 | 235 | 262 | 1.0 (reference) | 86 | 1.0 (reference) | 77 | 1.0 (reference) | 20 | 1.0 (reference) | 15 | 1.0 (reference) | ||
| 33.4+ | 154 | 202 | 1.0 (0.8, 1.4) | 80 | 1.2 (0.8, 1.8) | 40 | 0.7 (0.4, 1.1) | 11 | 0.8 (0.3, 1.7) | 33 | 3.0 (1.5, 5.9) | < .001 | CLL/SLL vs DLBCL, FL, MZ; P < .001 |
| Dietary PhIP, ng/d | |||||||||||||
| < 105.6 | 234 | 279 | 1.0 (reference) | 102 | 1.0 (reference) | 74 | 1.0 (reference) | 18 | 1.0 (reference) | 25 | 1.0 (reference) | ||
| 105.6+ | 155 | 185 | 0.8 (0.6, 1.1) | 64 | 0.7 (0.5, 1.1) | 43 | 0.7 (0.4, 1.1) | 13 | 0.9 (0.4, 2.0) | 23 | 1.2 (0.6, 2.3) | .4 | DLBCL, FL vs MZ, CLL/SLL; P = .03 |
BMI indicates body mass index; CLL/SLL, chronic lymphocytic leukemia/small lymphocytic lymphoma; DLBCL, diffuse large B-cell lymphoma; FL, follicular lymphoma; MZ, marginal zone lymphoma; MeIQx, 2-amino-3,8-dimethylimidazo-[4,5-f]quinoxaline; NHL, non-Hodgkin lymphoma; and PhIP, 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine.
Includes all NHL cases in the study, regardless of histologic subtype (N = 1320, excludes one DLBCL case resulting from missing data on education).
Counts may not sum to the total because of missing data. For some exposures (Table 1), a split-sample design was used so that only approximately 50% of participants were expected to provide information.
Odds ratios (95% CIs) estimated using polytomous logistic regression models, adjusted for age, sex, race, study center, and education.
To account for the seven comparisons within the pairwise analysis, we applied a Bonferroni correction and considered P < .007 to be statistically significant.
For cigarette smoking, the homogeneity test and pairwise analysis were conducted comparing current smokers to never smokers; former smokers were excluded from these analyses.