Current Understanding of Lifestyle and Environmental Factors and Risk of Non-Hodgkin Lymphoma: An Epidemiological Update

The incidence rates of non-Hodgkin lymphoma (NHL) have steadily increased over the last several decades in the United States, and the temporal trends in incidence can only be partially explained by the HIV epidemic. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an “emerging epidemic” of NHL and emphasized the need to investigate the factors responsible for the increasing incidence of this disease. Over the past two decades, numerous epidemiological studies have examined the risk factors for NHL, particularly for putative environmental and lifestyle risk factors, and international consortia have been established in order to investigate rare exposures and NHL subtype-specific associations. While few consistent risk factors for NHL aside from immunosuppression and certain infectious agents have emerged, suggestive associations with several lifestyle and environmental factors have been reported in epidemiologic studies. Further, increasing evidence has suggested that the effects of these and other exposures may be limited to or stronger for particular NHL subtypes. This paper examines the progress that has been made over the last twenty years in elucidating the etiology of NHL, with a primary emphasis on lifestyle factors and environmental exposures.

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Non-Hodgkin Lymphoma in the Middle East Is Characterized by Low Incidence Rates With Advancing Age

Journal of Global Oncology ◽

10.1200/jgo.18.00241 ◽

2019 ◽

pp. 1-10

Author(s):

Rafil T. Yaqo ◽

Sana D. Jalal ◽

Kharaman J. Ghafour ◽

Hemin A. Hassan ◽

Michael D. Hughson

Keyword(s):

United States ◽

Saudi Arabia ◽

Middle East ◽

Hodgkin Lymphoma ◽

Middle Eastern ◽

B Cell Lymphoma ◽

Cancer Registries ◽

The United States ◽

Incidence Rates ◽

Non Hodgkin Lymphoma

PURPOSE In the Middle East, incidence rate ratios (IRRs) of non-Hodgkin lymphoma (NHL) to Hodgkin lymphoma (HL) are more than 50% lower than the United States. MATERIALS AND METHODS Age-specific incidence rates (ASIRs), age-adjusted incidence rates (AAIRs), and IRRs of NHL:HL were compared using the cancer registries of Iraq, Jordan, Saudi Arabia, and US SEER. RESULTS The NHL AAIR (95% CI) per 100,000 population was 4.4 (4.1 to 4.7) for Iraq, 5.4 (4.6 to 6.2) for Jordan, 4.7 (4.4 to 5.1) for Saudi Arabia, and 13.2 (13.0 to 13.4) for the United States. The HL AAIR was 1.8 (1.6 to 2.0) for Iraq, 1.8 (1.4 to 2.2) for Jordan, 2.1 (1.9 to 2.2) for Saudi Arabia, and 2.3 (2.2 to 2.4) for the United States, with respective NHL:HL IRR of 2.4 (2.2 to 2.7), 3.0 (2.4 to 3.8), 2.2 (2.0 to 2.5), and 5.7 (5.5 to 6.0). NHL ASIRs for the Middle East and the United States were similar until 30 to 39 years of age. Thereafter, ASIR of NHL peaked at 20 to 33 per 100,000 at age 70 years in the Middle East regions, all much lower than the US age 70 years rate of greater than 100 per 100,000. Diffuse large B-cell lymphoma (DLBCL) represented 52% of NHL in Sulaimaniyah Province of Iraq and 51% of NHL in Saudi Arabia. Both regions had AAIR for DLBCL less than 42% of DLBCL in US SEER. Pediatric Epstein-Barr virus–related Burkitt’s lymphoma at 8% was the second most frequent NHL in Sulaimaniyah but made little contribution to overall NHL rates. CONCLUSION The incidence of HL was slightly lower than in the United States, but it was the markedly lower rates of adult NHL with advancing age, including the predominant DLBCL, that accounted for the low NHL:HL IRR in these Middle Eastern countries.

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Changes in Clinical Context for Kaposi's Sarcoma and Non-Hodgkin Lymphoma Among People With HIV Infection in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2016.67.6999 ◽

2016 ◽

Vol 34 (27) ◽

pp. 3276-3283 ◽

Cited By ~ 17

Author(s):

Elizabeth L. Yanik ◽

Chad J. Achenbach ◽

Satish Gopal ◽

Anna E. Coghill ◽

Stephen R. Cole ◽

...

Keyword(s):

United States ◽

Hiv Infection ◽

Hodgkin Lymphoma ◽

The United States ◽

Incidence Rates ◽

Cd4 Counts ◽

Hiv Rna ◽

Non Hodgkin Lymphoma ◽

Art Initiation ◽

Over Time

Purpose The biology of HIV-associated cancers may differ depending on immunologic and virologic context during development. Therefore, an understanding of the burden of Kaposi's sarcoma (KS) and non-Hodgkin lymphoma (NHL) relative to antiretroviral therapy (ART), virologic suppression, and CD4 count is important. Patients and Methods KS and NHL diagnoses during 1996 to 2011 were identified among patients with HIV infection in eight clinical cohorts in the United States. Among patients in routine HIV clinical care, the proportion of cases in categories of ART use, HIV RNA, and CD4 count at diagnosis were described across calendar time. Person-time and incidence rates were calculated for each category. Results We identified 466 patients with KS and 258 with NHL. In recent years, KS was more frequently diagnosed after ART initiation (55% in 1996 to 2001 v 76% in 2007 to 2011; P-trend = .02). The proportion of patients with NHL who received ART was higher but stable over time (83% overall; P-trend = .81). An increasing proportion of KS and NHL occurred at higher CD4 counts (P < .05 for KS and NHL) and with undetectable HIV RNA (P < .05 for KS and NHL). In recent years, more person-time was contributed by patients who received ART, had high CD4 counts and had undetectable HIV RNA, whereas incidence rates in these same categories remained stable or declined. Conclusion Over time, KS and NHL occurred at higher CD4 counts and lower HIV RNA values, and KS occurred more frequently after ART initiation. These changes were driven by an increasing proportion of patients with HIV who received effective ART, had higher CD4 counts, and had suppressed HIV RNA and not by increases in cancer risk within these subgroups. An improved understanding of HIV-associated cancer pathogenesis and outcomes in the context of successful ART is therefore important.

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Declining Incidence of Contralateral Breast Cancer in the United States From 1975 to 2006

Journal of Clinical Oncology ◽

10.1200/jco.2010.32.7395 ◽

2011 ◽

Vol 29 (12) ◽

pp. 1564-1569 ◽

Cited By ~ 144

Author(s):

Hazel B. Nichols ◽

Amy Berrington de González ◽

James V. Lacey ◽

Philip S. Rosenberg ◽

William F. Anderson

Keyword(s):

Breast Cancer ◽

United States ◽

Contralateral Breast Cancer ◽

Temporal Trends ◽

The United States ◽

Incidence Rates ◽

Contralateral Breast ◽

Breast Cancers ◽

Annual Percent Change ◽

Er Positive

Purpose Contralateral breast cancer (CBC) is the most frequent new malignancy among women diagnosed with a first breast cancer. Although temporal trends for first breast cancers have been well studied, trends for CBC are not so well established. Patients and Methods We examined temporal trends in CBC incidence using US Surveillance, Epidemiology, and End Results database (1975 to 2006). Data were stratified by estrogen receptor (ER) status of the first breast cancer for the available time period (1990+). We estimated the annual percent change (EAPC) in CBC rates using Poisson regression models adjusted for the age at and time since first breast cancer diagnosis. Results Before 1985, CBC incidence rates were stable (EAPC, 0.27% per year; 95% CI, −0.4 to 0.9), after which they declined with an EAPC of −3.07% per year (95% CI, −3.5 to −2.7). From 1990 forward, the declines were restricted to CBC after an ER-positive cancer (EAPC, −3.18%; 95% CI, −4.2 to −2.2) with no clear decreases after an ER-negative cancer. Estimated current age-specific CBC rates (per 100/year) after an ER-positive first cancer were: 0.45 for first cancers diagnosed before age 30 years and 0.25 to 0.37 for age 30 years or older. Rates after an ER-negative cancer were higher: 1.26 before age 30 years, 0.85 for age 30 to 35 years, and 0.45 to 0.65 for age 40 or older. Conclusion Results show a favorable decrease of 3% per year for CBC incidence in the United States since 1985. This overall trend was driven by declining CBC rates after an ER-positive cancer, possibly because of the widespread usage of adjuvant hormone therapies, after the results of the Nolvadex Adjuvant Trial Organisation were published in 1983, and/or other adjuvant treatments.

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Abstract 5501: The non-Hodgkin lymphoma epidemic in the United States: Recent trends in the absence of HIV-related cases

10.1158/1538-7445.am2012-5501 ◽

2012 ◽

Author(s):

Meredith S. Shiels ◽

Eric A. Engels ◽

Christina Clarke ◽

H. Irene Hall ◽

Patricia Hartge ◽

...

Keyword(s):

United States ◽

Hodgkin Lymphoma ◽

The United States ◽

Non Hodgkin Lymphoma ◽

Recent Trends

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Complications and hospital costs during hematopoietic stem cell transplantation for non-Hodgkin lymphoma in the United States

Leukemia & Lymphoma ◽

10.1080/10428194.2019.1581932 ◽

2019 ◽

Vol 60 (10) ◽

pp. 2464-2470 ◽

Cited By ~ 2

Author(s):

Sang Kyu Cho ◽

Jeffrey McCombs ◽

Nathan Punwani ◽

Jenny Lam

Keyword(s):

United States ◽

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Hodgkin Lymphoma ◽

Cell Transplantation ◽

Hospital Costs ◽

The United States ◽

Hematopoietic Stem ◽

Non Hodgkin Lymphoma

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Esophageal Adenocarcinoma: Opportunities for Targeted Prevention in Ohio

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552218791170 ◽

2018 ◽

Vol 11 ◽

pp. 117955221879117 ◽

Cited By ~ 1

Author(s):

Julie A Stephens ◽

James L Fisher ◽

Jessica L Krok-Schoen ◽

Ryan D Baltic ◽

Holly L Sobotka ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Risk Factor ◽

Cigarette Smoking ◽

Esophageal Adenocarcinoma ◽

Surveillance System ◽

The United States ◽

Incidence Rates ◽

Targeted Prevention ◽

Care Providers

Objective: The incidence of esophageal adenocarcinoma, one of the most lethal gastroenterological diseases, has been increasing since the 1960s. Prevention of esophageal adenocarcinoma is important because no early detection screening programs have been shown to reduce mortality. Obesity, gastroesophageal reflux disease, and tobacco smoking are risk factors for esophageal adenocarcinoma. Due to the high prevalence in Ohio of obesity (32.6%) and cigarette smoking (21.0%), this study sought to identify trends and patterns of these risk factors and esophageal adenocarcinoma in Ohio as compared with the United States. Methods: Data from the Ohio Cancer Incidence Surveillance System, Surveillance Epidemiology and End Results Program (SEER), and Behavioral Risk Factor Surveillance System were used. Incidence rates overall, by demographics and by county, as well as trends in incidence of esophageal adenocarcinoma and the percent of esophageal adenocarcinoma among esophageal cancers were examined. Trends in obesity and cigarette smoking in Ohio, and the prevalence of each by county, were reported. Results: There was an increasing trend in esophageal adenocarcinoma incidence in Ohio. Ohio’s average annual esophageal adenocarcinoma incidence rate was higher than the SEER rate overall and for each sex, race, and age group in 2009 to 2013. There was also an increasing prevalence of obesity in Ohio. Although the prevalence of cigarette smoking has been stable, it was high in Ohio compared with the United States. Conclusions: Health care providers and researchers should be aware of the esophageal adenocarcinoma incidence rates and risk factor patterns and tailor interventions for areas and populations at higher risk.

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Anaphylaxis in Pregnancy in the United States: Risk Factors and Temporal Trends Using National Routinely Collected Data

The Journal of Allergy and Clinical Immunology In Practice ◽

10.1016/j.jaip.2019.04.047 ◽

2019 ◽

Vol 7 (8) ◽

pp. 2606-2612.e3 ◽

Cited By ~ 5

Author(s):

Stephen J. McCall ◽

Jennifer J. Kurinczuk ◽

Marian Knight

Keyword(s):

United States ◽

Risk Factors ◽

Temporal Trends ◽

The United States ◽

Routinely Collected Data ◽

In Pregnancy

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Temporal Changes in Head and Neck Cancer Incidence in Thailand Suggest Changing Oropharyngeal Epidemiology in the Region

Journal of Global Oncology ◽

10.1200/jgo.18.00219 ◽

2019 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Ilona Argirion ◽

Katie R. Zarins ◽

Kali Defever ◽

Krittika Suwanrungruang ◽

Joanne T. Chang ◽

...

Keyword(s):

United States ◽

Head And Neck Cancer ◽

Oral Cavity ◽

Head And Neck ◽

Neck Cancer ◽

Temporal Trends ◽

The United States ◽

Incidence Rates ◽

Khon Kaen ◽

Icd10 Code

PURPOSE Head and neck cancer is the sixth most common cancer in the world, and the largest burden occurs in developing countries. Although the primary risk factors have been well characterized, little is known about temporal trends in head and neck cancer across Thailand. METHODS Head and neck squamous cell carcinoma (HNSCC) occurrences diagnosed between 1990 and 2014 were selected by International Classification of Diseases (10th revision; ICD10) code from the Songkhla, Lampang, Chiang Mai, and Khon Kaen cancer registries and the US SEER program for oral cavity (ICD10 codes 00, 03-06), tongue (ICD10 codes 01-02), pharynx (ICD10 codes 09-10, 12-14), and larynx (ICD10 code 32). The data were analyzed using R and Joinpoint regression software to determine age-standardized incidence rates and trends of annual percent change (APC). Incidence rates were standardized using the Segi (1960) population. Stratified linear regression models were conducted to assess temporal trends in early-onset HNSCC across 20-year age groups. RESULTS Although overall HNSCC rates are decreasing across all registries, subsite analyses demonstrate consistent decreases in both larynx and oral cavity cancers but suggest increases in tongue cancers among both sexes in the United States (APCmen, 2.36; APCwomen, 0.77) and in pharyngeal cancer in Khon Kaen and US men (APC, 2.1 and 2.23, respectively). Age-stratified APC analyses to assess young-onset (< 60 years old) trends demonstrated increased incidence in tongue cancer in Thailand and the United States as well as in pharyngeal cancers in Khon Kaen men age 40 to 59 years and US men age 50 to 59 years. CONCLUSION Although overall trends in HNSCC are decreasing across both Thailand and the United States, there is reason to believe that the etiologic shift to oropharyngeal cancers in the United States may be occurring in Thailand.

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