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. 2003 Nov;111(14):1704–1706. doi: 10.1289/ehp.6270

Is the decline of the increasing incidence of non-Hodgkin lymphoma in Sweden and other countries a result of cancer preventive measures?

Lennart Hardell 1, Mikael Eriksson 1
PMCID: PMC1241710  PMID: 14594618

Abstract

Is the decline of the increasing incidence of non-Hodgkin lymphoma (NHL) in Sweden and other countries a result of cancer preventive measures? The yearly age-standardized incidence of NHL increased significantly in Sweden during 1971-1990, for men an average of 3.2% and for women 3.1%. The corresponding figures for 1991-2000 were -0.8% and -0.2%, respectively. A decline of the increasing incidence has also been seen in other countries, such as the United States, Finland, and Denmark. Immunosuppression is one established risk factor for NHL, possibly with interaction with Epstein-Barr virus. Phenoxyacetic acids and chlorophenols, both pesticides, have been associated with NHL. Use of these chemicals was banned in Sweden in 1977 and 1978, respectively. Also, persistent organic pollutants such as polychlorinated biphenyls, hexachlorobenzene, chlordanes, and dioxins have been shown to increase the risk. Exposure of the whole population occurs predominantly through the food chain. Exposure to such chemicals was highest in the 1960s and 1970s. Because of regulation in the 1970s, exposure has declined substantially in the population. The change in incidence of NHL in Sweden and other countries may serve as a good example of how prohibition and limitation of exposure may be reflected in cancer statistics some decades later.

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Selected References

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  1. Evans A. S., Mueller N. E. Viruses and cancer. Causal associations. Ann Epidemiol. 1990 Oct;1(1):71–92. doi: 10.1016/1047-2797(90)90020-s. [DOI] [PubMed] [Google Scholar]
  2. Hardell E., Eriksson M., Lindström G., Van Bavel B., Linde A., Carlberg M., Liljegren G. Case-control study on concentrations of organohalogen compounds and titers of antibodies to Epstein-Barr virus antigens in the etiology of non-Hodgkin lymphoma. Leuk Lymphoma. 2001 Aug;42(4):619–629. doi: 10.3109/10428190109099322. [DOI] [PubMed] [Google Scholar]
  3. Hardell L., Eriksson M. A case-control study of non-Hodgkin lymphoma and exposure to pesticides. Cancer. 1999 Mar 15;85(6):1353–1360. doi: 10.1002/(sici)1097-0142(19990315)85:6<1353::aid-cncr19>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  4. Hardell L., Eriksson M., Degerman A. Exposure to phenoxyacetic acids, chlorophenols, or organic solvents in relation to histopathology, stage, and anatomical localization of non-Hodgkin's lymphoma. Cancer Res. 1994 May 1;54(9):2386–2389. [PubMed] [Google Scholar]
  5. Hardell L., Eriksson M., Lenner P., Lundgren E. Malignant lymphoma and exposure to chemicals, especially organic solvents, chlorophenols and phenoxy acids: a case-control study. Br J Cancer. 1981 Feb;43(2):169–176. doi: 10.1038/bjc.1981.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hardell L., Lindström G., van Bavel B., Hardell K., Linde A., Carlberg M., Liljegren G. Adipose tissue concentrations of dioxins and dibenzofurans, titers of antibodies to Epstein-Barr virus early antigen and the risk for non-Hodgkin lymphoma. Environ Res. 2001 Oct;87(2):99–107. doi: 10.1006/enrs.2001.4295. [DOI] [PubMed] [Google Scholar]
  7. Hardell L. Malignant lymphoma of histiocytic type and exposure to phenoxyacetic acids or chlorophenols. Lancet. 1979 Jan 6;1(8106):55–56. doi: 10.1016/s0140-6736(79)90509-9. [DOI] [PubMed] [Google Scholar]
  8. Hardell Lennart, Eriksson Mikael, Nordstrom Marie. Exposure to pesticides as risk factor for non-Hodgkin's lymphoma and hairy cell leukemia: pooled analysis of two Swedish case-control studies. Leuk Lymphoma. 2002 May;43(5):1043–1049. doi: 10.1080/10428190290021560. [DOI] [PubMed] [Google Scholar]
  9. Hoar S. K., Blair A., Holmes F. F., Boysen C. D., Robel R. J., Hoover R., Fraumeni J. F., Jr Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA. 1986 Sep 5;256(9):1141–1147. [PubMed] [Google Scholar]
  10. Lehtinen T., Lumio J., Dillner J., Hakama M., Knekt P., Lehtinen M., Teppo L., Leinikki P. Increased risk of malignant lymphoma indicated by elevated Epstein-Barr virus antibodies--a prospective study. Cancer Causes Control. 1993 May;4(3):187–193. doi: 10.1007/BF00051312. [DOI] [PubMed] [Google Scholar]
  11. Newstead C. G. Assessment of risk of cancer after renal transplantation. Lancet. 1998 Feb 28;351(9103):610–611. doi: 10.1016/s0140-6736(98)22009-5. [DOI] [PubMed] [Google Scholar]
  12. Nordström M., Hardell L., Linde A., Schloss L., Näsman A. Elevated antibody levels to Epstein-Bbarr virus antigens in patients with hairy cell leukemia compared to controls in relation to exposure to pesticides, organic solvents, animals, and exhausts. Oncol Res. 1999;11(11-12):539–544. [PubMed] [Google Scholar]
  13. Nordström M., Hardell L., Lindström G., Wingfors H., Hardell K., Linde A. Concentrations of organochlorines related to titers to Epstein-Barr virus early antigen IgG as risk factors for hairy cell leukemia. Environ Health Perspect. 2000 May;108(5):441–445. doi: 10.1289/ehp.108-1638040. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Norén K., Meironyté D. Certain organochlorine and organobromine contaminants in Swedish human milk in perspective of past 20-30 years. Chemosphere. 2000 May-Jun;40(9-11):1111–1123. doi: 10.1016/s0045-6535(99)00360-4. [DOI] [PubMed] [Google Scholar]
  15. Patton D. F., Wilkowski C. W., Hanson C. A., Shapiro R., Gajl-Peczalska K. J., Filipovich A. H., McClain K. L. Epstein-Barr virus--determined clonality in posttransplant lymphoproliferative disease. Transplantation. 1990 Jun;49(6):1080–1084. doi: 10.1097/00007890-199006000-00010. [DOI] [PubMed] [Google Scholar]
  16. Persson B., Dahlander A. M., Fredriksson M., Brage H. N., Ohlson C. G., Axelson O. Malignant lymphomas and occupational exposures. Br J Ind Med. 1989 Aug;46(8):516–520. doi: 10.1136/oem.46.8.516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Pluda J. M., Venzon D. J., Tosato G., Lietzau J., Wyvill K., Nelson D. L., Jaffe E. S., Karp J. E., Broder S., Yarchoan R. Parameters affecting the development of non-Hodgkin's lymphoma in patients with severe human immunodeficiency virus infection receiving antiretroviral therapy. J Clin Oncol. 1993 Jun;11(6):1099–1107. doi: 10.1200/JCO.1993.11.6.1099. [DOI] [PubMed] [Google Scholar]
  18. Rothman N., Cantor K. P., Blair A., Bush D., Brock J. W., Helzlsouer K., Zahm S. H., Needham L. L., Pearson G. R., Hoover R. N. A nested case-control study of non-Hodgkin lymphoma and serum organochlorine residues. Lancet. 1997 Jul 26;350(9073):240–244. doi: 10.1016/S0140-6736(97)02088-6. [DOI] [PubMed] [Google Scholar]
  19. Zahm S. H., Weisenburger D. D., Babbitt P. A., Saal R. C., Vaught J. B., Cantor K. P., Blair A. A case-control study of non-Hodgkin's lymphoma and the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) in eastern Nebraska. Epidemiology. 1990 Sep;1(5):349–356. doi: 10.1097/00001648-199009000-00004. [DOI] [PubMed] [Google Scholar]
  20. Zahm S. H., Weisenburger D. D., Babbitt P. A., Saal R. C., Vaught J. B., Cantor K. P., Blair A. A case-control study of non-Hodgkin's lymphoma and the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) in eastern Nebraska. Epidemiology. 1990 Sep;1(5):349–356. doi: 10.1097/00001648-199009000-00004. [DOI] [PubMed] [Google Scholar]

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