Smoking and Hematolymphopoietic Malignancies

• Published in: Cancer causes & control 2001-05, Vol.12 (4), p.325-334
• Main Authors: Stagnaro, E., Ramazzotti, V., Crosignani, P., Fontana, A., Masala, G., Miligi, L., Nanni, O., Neri, M., Rodella, S., Costantini, A. Seniori, Tumino, R., Viganò, C., Vindigni, C., Vineis, P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cancer; Carcinogens; Case control studies; Cigarette smoking; Cigarettes; Cohort Studies; Female; Hodgkin disease; Hodgkin Disease - epidemiology; Hodgkin Disease - etiology; Hospitals; Humans; Interviews; Italy - epidemiology; Leukemia; Leukemia - epidemiology; Leukemia - etiology; Logistic Models; Lymphoma; Lymphoma, Non-Hodgkin - epidemiology; Lymphoma, Non-Hodgkin - etiology; Male; Men; Middle Aged; Multiple myeloma; Multiple Myeloma - epidemiology; Multiple Myeloma - etiology; Non Hodgkin lymphoma; Odds Ratio; Population; Research Papers; Risk Factors; Sex Factors; Smoking; Smoking - adverse effects; Surveys and Questionnaires; Tobacco smoke
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1023/A:1011216102871

Objective: Tobacco use is the most prominent cause of respiratory cancers. Little is known, however, about the influence of smoking on hematolymphopoietic malignancies. To evaluate this relation, a population-based case-control study was carried out in 12 areas of Italy. Methods: Detailed interviews on tobacco smoking habits were administered to 1450 non-Hodgkin's lymphoma (NHL), 365 Hodgkin's disease (HD), 270 multiple myeloma (MM), and 649 leukemia (LEU) patients occurring from 1990 to 1993, and 1779 population controls. Results: We found a slightly increased risk for NHL in smokers (odds ratio 1.2, 95% confidence interval 1.0-1.4 for ever smokers), but a consistent positive association was shown only for follicular NHL. In this subtype, a significant excess risk was observed for ever versus never smokers, after adjustment for gender, age, geographic residence, education, and respondent (OR = 1.8, 95%, CI 1.3-2.7), with a positive exposure-response gradient for smoking duration (p < 0.01). The risk for follicular NHL was significantly elevated only among women, with ever smokers showing OR = 2.3 (CI 1.4-3.8), while for men we found OR = 1.3 (CI 0.69-2.3). No major differences were shown according to age. Female subjects also showed significant positive exposure-response trends for duration. Conclusion: Cigarette smoking could be a risk factor for follicular NHL among women. For HD, MM, or LEU, no clear association was observed.