IJE Advance Access originally published online on May 29, 2008
International Journal of Epidemiology 2008 37(5):1080-1094; doi:10.1093/ije/dyn092
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Exposure to ultraviolet radiation and risk of malignant lymphoma and multiple myeloma—a multicentre European case–control study
1 International Agency for Research on Cancer, Lyon, France.
2 University of Sydney, Sydney, Australia.
3 German Cancer Research Center, Heidelberg, Germany.
4 Catalan Institute of Oncology, Barcelona, Spain.
5 Burgundy University (EA4184), Universitary Hospital, Dijon, France.
6 Institute of Occupational Medicine, University of Cagliari, Italy.
7 Public Health University College Dublin, Ireland.
8 Centre for Public Health Research, Massey University, Wellington, New Zealand.
* Corresponding author. Lifestyle, Environment and Cancer Group, International Agency for Research on Cancer, 150 cours Albert-Thomas, 69008 Lyon, France. E-mail: boffetta{at}iarc.fr
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Abstract |
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Background Three recent studies have reported a decreased risk of non-Hodgkin lymphoma (NHL) for high ultraviolet (UV) radiation exposure.
Methods We conducted a multicentre case–control study during 1998–2004 in France, Germany, Ireland, Italy and Spain, comprising 1518 cases of NHL, 268 cases of Hodgkin lymphoma, 242 cases of multiple myeloma and 2124 population or hospital controls. We collected information on sensitivity to sun and personal exposure to UV radiation in childhood and adulthood via interview, and assessed occupational exposure to UV radiation from the occupational history.
Results The risk of Hodgkin and NHL was increased for increasing skin sensitivity to the sun [odds ratio (OR) for no suntan vs very brown 2.35, 95% CI 0.94–5.87 and 1.39, 95% CI 1.03–1.87, respectively]. The risk of diffuse large B-cell lymphoma was reduced for increasing adult personal (OR for highest vs lowest quartile of exposure in free days 0.62, 95% CI 0.44–0.87) and for occupational exposure to UV radiation (OR for highest vs lowest exposure tertile 0.63, 95% CI 0.37–1.04). The risk of multiple myeloma was increased for personal exposure to UV radiation during adulthood (OR for highest vs lowest quartile of exposure in free days 1.49, 95% CI 0.88–2.50). A protective effect was observed for use of sun lamps for diffuse large B-cell lymphoma (OR for 25+ times vs never 0.63, 95% CI 0.38–1.03).
Conclusions The hypothesis of a protective effect of UV radiation on lymphoma is supported by our results. The underlying mechanisms might differ from those operating in skin carcinogenesis. The increased risk of multiple myeloma is worth replication.
Keywords Non-Hodgkin lymphoma, UV radiation, multiple myeloma, Hodgkin lymphoma, lymphoma, epidemiology
Accepted 29 April 2008
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