Cigarette smoking and risk of non-Hodgkin lymphoma: A pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)

Lindsay M. Morton, Patricia Hartge, Theodore R. Holford, Elizabeth A. Holly, Brian C.H. Chiu, Paolo Vincis, Emanuele Siagnaro, Eleanor V. Willett, Silvia Franceschi, Carlo La Vecchia, Ann Maree Hughes, Wendy Cozen, Scott Davis, Richard K. Severson, Leslie Bernstein, Susan T. Mayne, Fred R. Dee, James R. Cerhan, Tongzhang Zheng

Research output: Contribution to journalArticlepeer-review

148 Scopus citations


Background: The International Lymphoma Epidemiology Consortium (InterLymph) provides an opportunity to analyze the relationship between cigarette smoking and non-Hodgkin lymphoma with sufficient statistical power to consider non-Hodgkin lymphoma subtype. The results from previous studies of this relationship have been inconsistent, likely due to the small sample sizes that arose from stratification by disease subtype. To clarify the role of cigarette smoking in the etiology of non-Hodgkin lymphoma, we conducted a pooled analysis of original patient data from nine case-control studies of non-Hodgkin lymphoma conducted in the United States, Europe, and Australia. Methods: Original data were obtained from each study and uniformly coded. Risk estimates from fixed-effects and two-stage random-effects models were compared to determine the impact of interstudy heterogeneity. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from unconditional logistic regression models, controlling for study center, age, sex, and race. Results: In our pooled study population of 6,594 cases and 8,892 controls, smoking was associated with slightly increased risk estimates (OR, 1.07; 95% CI, 1.00-1.15). Stratification by non-Hodgkin lymphoma subtype revealed that the most consistent association between cigarette smoking and non-Hodgkin lymphoma was observed among follicular lymphomas (n = 1452). Compared with nonsmokers, current smokers had a higher OR for follicular lymphoma (1.31; 95% CI, 1.12-1.52) than former smokers (1.06; 95% CI, 0.93-1.22). Current heavy smoking (≥36 pack-years) was associated with a 45% increased OR for follicular lymphoma (1.45; 95% CI, 1.15-1.82) compared with nonsmokers. Conclusions: Cigarette smoking may increase the risk of developing follicular lymphoma but does not seem to affect risk of the other non-Hodgkin lymphoma subtypes we examined. Future research is needed to determine the biological mechanism responsible for our subtype-specific results.

Original languageEnglish (US)
Pages (from-to)925-933
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Issue number4
StatePublished - Apr 2005

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Cigarette smoking and risk of non-Hodgkin lymphoma: A pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)'. Together they form a unique fingerprint.

Cite this