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Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition

  • Silke Hermann
  • , Sabine Rohrmann
  • , Jakob Linseisen
  • , Alexandra Nieters
  • , Aneire Khan
  • , Valentina Gallo
  • , Kim Overvad
  • , Anne Tjønneland
  • , Ole Raaschou-Nielsen
  • , Manuela M. Bergmann
  • , Heiner Boeing
  • , Nikolaus Becker
  • , Rudolf Kaaks
  • , H. Bas Bueno-De-Mesquita
  • , Anne M. May
  • , Roel C.H. Vermeulen
  • , Sheila Bingham
  • , Kay Tee Khaw
  • , Timothy J. Key
  • , Ruth C. Travis
  • Antonia Trichopoulou, Christina Georgila, Dimitra Triantafylou, Egidio Celentano, Vittorio Krogh, Giovanna Masala, Rosario Tumino, Antonio Agudo, Jone M. Altzibar, Eva Ardanaz, Carmen Martínez-García, Marcial Vicente Argüelles Suárez, Maria José Tormo, Tonje Braaten, Eiliv Lund, Jonas Manjer, Sophia Zackrisson, Göran Hallmans, Beatrice Malmer, Paolo Boffetta, Paul Brennan, Nadia Slimani, Paolo Vineis, Elio Riboli
  • German Cancer Research Center
  • Imperial College London
  • Aarhus University
  • Danish Cancer Society
  • German Institute of Human Nutrition Potsdam-Rehbruecke
  • National Institute of Public Health and the Environment
  • Utrecht University
  • MRC Mitochondrial Biology Unit
  • University of Cambridge
  • University of Oxford
  • National and Kapodistrian University of Athens
  • IRCCS Istituto nazionale tumori Fondazione Giovanni Pascale - Napoli
  • IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori - Milano
  • Centro Per Lo Studio E La Prevenzione Oncologica
  • Azienda Ospedaliera Civile M.P. Arezzo
  • Institute Catala Oncologia
  • Public Health Division of Gipuzkoa
  • CIBER Epidemiología y Salud Pública (CIBERESP)
  • Instituto de Salud Publica, Pamplona
  • Escuela Andaluza de Salud Publica
  • Health and Health Services Council of Asturias
  • IMIB-Arrixaca
  • University of Tromsø – The Arctic University of Norway
  • Lund University
  • Umeå University
  • International Agency for Research on Cancer

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Introduction: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study. Materials and methods: Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk. Results: Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02-1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27-0.79) versus lowest educational level. No association was found for HL. Conclusion: We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalJournal of Cancer Research and Clinical Oncology
Volume136
Issue number1
DOIs
StatePublished - Jan 2010

Keywords

  • Cohort study
  • Education
  • Lymphomas
  • SES

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