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. 1999 Jul;80(9):1476–1482. doi: 10.1038/sj.bjc.6690547

Alcohol consumption and non-Hodgkin lymphoma in a cohort of older women

B C-H Chiu 1,2, J R Cerhan 1, S M Gapstur 2, T A Sellers 3, W Zheng 4, C T Lutz 5, R B Wallace 1, J D Potter 6
PMCID: PMC2363074  PMID: 10424754

Abstract

We investigated the relation of alcohol consumption to risk of non-Hodgkin's lymphoma (NHL) in a cohort of 35 156 lowa women aged 55–69 years who participated in the lowa Women's Health Study in 1986. Alcohol consumption at baseline was obtained using a mailed questionnaire. During the 9-year follow-up period, 143 incident cases of NHL were identified. Higher alcohol consumption was significantly associated with a decreased risk of NHL (P-trend = 0.03). Compared to non-drinkers, multivariate-adjusted relative risks (RRs) were decreased for women with intake of ≤ 3.4 g day−1 (RR = 0.78; 95% confidence interval (CI) 0.51–1.21) and > 3.4 g day−1 (RR = 0.59; 0.36–0.97). The inverse association could not be attributed to one particular type of alcoholic beverage, although red wine (RR = 0.21 for > 2 glasses per month vs non-drinker; 0.05–0.86; P-trend = 0.02) has the most distinct effect. The apparent protective effect was universal regardless of specific NHL grade or Working Formulation subtype, but was most pronounced for nodal NHL (RR = 0.48; 0.26–0.90; P-trend = 0.01) and low-grade NHL (RR = 0.52; 0.21–1.26; P-trend = 0.05). These data suggest that moderate alcohol consumption is inversely associated with the risk of NHL in older women and the amount of alcohol consumed, rather than the type of alcoholic beverages, appears to be the main effect determinant. © 1999 Cancer Research Campaign

Keywords: lymphoma, alcohol, non-Hodgkin, cohort study

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Selected References

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  1. Ballester O. F., Moscinski L., Spiers A., Balducci L. Non-Hodgkin's lymphoma in the older person: a review. J Am Geriatr Soc. 1993 Nov;41(11):1245–1254. doi: 10.1111/j.1532-5415.1993.tb07310.x. [DOI] [PubMed] [Google Scholar]
  2. Bell D. S. Alcohol and the NIDDM patient. Diabetes Care. 1996 May;19(5):509–513. doi: 10.2337/diacare.19.5.509. [DOI] [PubMed] [Google Scholar]
  3. Bisgard K. M., Folsom A. R., Hong C. P., Sellers T. A. Mortality and cancer rates in nonrespondents to a prospective study of older women: 5-year follow-up. Am J Epidemiol. 1994 May 15;139(10):990–1000. doi: 10.1093/oxfordjournals.aje.a116948. [DOI] [PubMed] [Google Scholar]
  4. Bounds W., Betzing K. W., Stewart R. M., Holcombe R. F. Social drinking and the immune response: impairment of lymphokine-activated killer activity. Am J Med Sci. 1994 Jun;307(6):391–395. doi: 10.1097/00000441-199406000-00001. [DOI] [PubMed] [Google Scholar]
  5. Brown L. M., Gibson R., Burmeister L. F., Schuman L. M., Everett G. D., Blair A. Alcohol consumption and risk of leukemia, non-Hodgkin's lymphoma, and multiple myeloma. Leuk Res. 1992 Oct;16(10):979–984. doi: 10.1016/0145-2126(92)90077-k. [DOI] [PubMed] [Google Scholar]
  6. Cantor K. P., Blair A., Everett G., VanLier S., Burmeister L., Dick F. R., Gibson R. W., Schuman L. Hair dye use and risk of leukemia and lymphoma. Am J Public Health. 1988 May;78(5):570–571. doi: 10.2105/ajph.78.5.570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cartwright R. A., McKinney P. A., O'Brien C., Richards I. D., Roberts B., Lauder I., Darwin C. M., Bernard S. M., Bird C. C. Non-Hodgkin's lymphoma: case control epidemiological study in Yorkshire. Leuk Res. 1988;12(1):81–88. doi: 10.1016/s0145-2126(98)80012-x. [DOI] [PubMed] [Google Scholar]
  8. Cerhan J. R., Wallace R. B., Folsom A. R., Potter J. D., Munger R. G., Prineas R. J. Transfusion history and cancer risk in older women. Ann Intern Med. 1993 Jul 1;119(1):8–15. doi: 10.7326/0003-4819-119-1-199307010-00002. [DOI] [PubMed] [Google Scholar]
  9. Cerhan J. R., Wallace R. B., Folsom A. R., Potter J. D., Sellers T. A., Zheng W., Lutz C. T. Medical history risk factors for non-Hodgkin's lymphoma in older women. J Natl Cancer Inst. 1997 Feb 19;89(4):314–318. doi: 10.1093/jnci/89.4.314. [DOI] [PubMed] [Google Scholar]
  10. Chiu B. C., Cerhan J. R., Folsom A. R., Sellers T. A., Kushi L. H., Wallace R. B., Zheng W., Potter J. D. Diet and risk of non-Hodgkin lymphoma in older women. JAMA. 1996 May 1;275(17):1315–1321. doi: 10.1001/jama.1996.03530410029029. [DOI] [PubMed] [Google Scholar]
  11. De Stefani E., Fierro L., Barrios E., Ronco A. Tobacco, alcohol, diet and risk of non-Hodgkin's lymphoma: a case-control study in Uruguay. Leuk Res. 1998 May;22(5):445–452. doi: 10.1016/s0145-2126(97)00194-x. [DOI] [PubMed] [Google Scholar]
  12. Facchini F., Chen Y. D., Reaven G. M. Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabetes Care. 1994 Feb;17(2):115–119. doi: 10.2337/diacare.17.2.115. [DOI] [PubMed] [Google Scholar]
  13. Filipovich A. H., Mathur A., Kamat D., Shapiro R. S. Primary immunodeficiencies: genetic risk factors for lymphoma. Cancer Res. 1992 Oct 1;52(19 Suppl):5465s–5467s. [PubMed] [Google Scholar]
  14. Folsom A. R., Kaye S. A., Prineas R. J., Potter J. D., Gapstur S. M., Wallace R. B. Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol. 1990 May;131(5):794–803. doi: 10.1093/oxfordjournals.aje.a115570. [DOI] [PubMed] [Google Scholar]
  15. Folsom A. R., Zhang S., Sellers T. A., Zheng W., Kushi L. H., Cerhan J. R. Cancer incidence among women living on farms: findings from the Iowa Women's Health Study. J Occup Environ Med. 1996 Nov;38(11):1171–1176. doi: 10.1097/00043764-199611000-00018. [DOI] [PubMed] [Google Scholar]
  16. Franceschi S., Serraino D., Bidoli E., Talamini R., Tirelli U., Carbone A., La Vecchia C. The epidemiology of non-Hodgkin's lymphoma in the north-east of Italy: a hospital-based case-control study. Leuk Res. 1989;13(6):465–472. doi: 10.1016/0145-2126(89)90168-9. [DOI] [PubMed] [Google Scholar]
  17. Franceschi S., Serraino D., Carbone A., Talamini R., La Vecchia C. Dietary factors and non-Hodgkin's lymphoma: a case-control study in the northeastern part of Italy. Nutr Cancer. 1989;12(4):333–341. doi: 10.1080/01635588909514034. [DOI] [PubMed] [Google Scholar]
  18. Freund G. Possible relationships of alcohol in membranes to cancer. Cancer Res. 1979 Jul;39(7 Pt 2):2899–2901. [PubMed] [Google Scholar]
  19. Gapstur S. M., Potter J. D., Sellers T. A., Kushi L. H., Folsom A. R. Alcohol consumption and postmenopausal endometrial cancer: results from the Iowa Women's Health Study. Cancer Causes Control. 1993 Jul;4(4):323–329. doi: 10.1007/BF00051334. [DOI] [PubMed] [Google Scholar]
  20. Giovannucci E., Colditz G., Stampfer M. J., Rimm E. B., Litin L., Sampson L., Willett W. C. The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol. 1991 Apr 15;133(8):810–817. doi: 10.1093/oxfordjournals.aje.a115960. [DOI] [PubMed] [Google Scholar]
  21. Hoover R. N. Lymphoma risks in populations with altered immunity--a search for mechanism. Cancer Res. 1992 Oct 1;52(19 Suppl):5477s–5478s. [PubMed] [Google Scholar]
  22. Lazarus R., Sparrow D., Weiss S. T. Alcohol intake and insulin levels. The Normative Aging Study. Am J Epidemiol. 1997 May 15;145(10):909–916. doi: 10.1093/oxfordjournals.aje.a009050. [DOI] [PubMed] [Google Scholar]
  23. Lynch C. F., Logsden-Sackett N., Edwards S. L., Cantor K. P. The driver's license list as a population-based sampling frame in Iowa. Am J Public Health. 1994 Mar;84(3):469–472. doi: 10.2105/ajph.84.3.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. MacGregor R. R. Alcohol and immune defense. JAMA. 1986 Sep 19;256(11):1474–1479. [PubMed] [Google Scholar]
  25. Malvy D. J., Burtschy B., Arnaud J., Sommelet D., Leverger G., Dostalova L., Drucker J., Amédée-Manesme O. Serum beta-carotene and antioxidant micronutrients in children with cancer. The 'Cancer in Children and Antioxidant Micronutrients' French Study Group. Int J Epidemiol. 1993 Oct;22(5):761–771. doi: 10.1093/ije/22.5.761. [DOI] [PubMed] [Google Scholar]
  26. Mufti S. I., Darban H. R., Watson R. R. Alcohol, cancer, and immunomodulation. Crit Rev Oncol Hematol. 1989;9(3):243–261. doi: 10.1016/s1040-8428(89)80003-4. [DOI] [PubMed] [Google Scholar]
  27. Munger R. G., Folsom A. R., Kushi L. H., Kaye S. A., Sellers T. A. Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol. 1992 Jul 15;136(2):192–200. doi: 10.1093/oxfordjournals.aje.a116485. [DOI] [PubMed] [Google Scholar]
  28. Natazuka T., Manabe Y., Kono M., Murayama T., Matsui T., Chihara K. Association between non-insulin dependent diabetes mellitus and non-Hodgkin's lymphoma. BMJ. 1994 Nov 12;309(6964):1269–1269. doi: 10.1136/bmj.309.6964.1269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Nelson R. A., Levine A. M., Marks G., Bernstein L. Alcohol, tobacco and recreational drug use and the risk of non-Hodgkin's lymphoma. Br J Cancer. 1997;76(11):1532–1537. doi: 10.1038/bjc.1997.590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Ragozzino M., Melton L. J., 3rd, Chu C. P., Palumbo P. J. Subsequent cancer risk in the incidence cohort of Rochester, Minnesota, residents with diabetes mellitus. J Chronic Dis. 1982;35(1):13–19. doi: 10.1016/0021-9681(82)90025-x. [DOI] [PubMed] [Google Scholar]
  31. Rimm E. B., Chan J., Stampfer M. J., Colditz G. A., Willett W. C. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ. 1995 Mar 4;310(6979):555–559. doi: 10.1136/bmj.310.6979.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Shaper A. G., Wannamethee G., Walker M. Alcohol and mortality in British men: explaining the U-shaped curve. Lancet. 1988 Dec 3;2(8623):1267–1273. doi: 10.1016/s0140-6736(88)92890-5. [DOI] [PubMed] [Google Scholar]
  33. Stampfer M. J., Colditz G. A., Willett W. C., Manson J. E., Arky R. A., Hennekens C. H., Speizer F. E. A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J Epidemiol. 1988 Sep;128(3):549–558. doi: 10.1093/oxfordjournals.aje.a115002. [DOI] [PubMed] [Google Scholar]
  34. Tavani A., Negri E., Franceschi S., Serraino D., La Vecchia C. Smoking habits and non-Hodgkin's lymphoma: a case-control study in northern Italy. Prev Med. 1994 Jul;23(4):447–452. doi: 10.1006/pmed.1994.1061. [DOI] [PubMed] [Google Scholar]
  35. Tavani A., Pregnolato A., Negri E., Franceschi S., Serraino D., Carbone A., La Vecchia C. Diet and risk of lymphoid neoplasms and soft tissue sarcomas. Nutr Cancer. 1997;27(3):256–260. doi: 10.1080/01635589709514535. [DOI] [PubMed] [Google Scholar]
  36. Ward M. H., Zahm S. H., Weisenburger D. D., Gridley G., Cantor K. P., Saal R. C., Blair A. Dietary factors and non-Hodgkin's lymphoma in Nebraska (United States). Cancer Causes Control. 1994 Sep;5(5):422–432. doi: 10.1007/BF01694756. [DOI] [PubMed] [Google Scholar]
  37. Weisenburger D. D. Epidemiology of non-Hodgkin's lymphoma: recent findings regarding an emerging epidemic. Ann Oncol. 1994;5 (Suppl 1):19–24. doi: 10.1093/annonc/5.suppl_1.s19. [DOI] [PubMed] [Google Scholar]
  38. Whitehead T. P., Robinson D., Allaway S., Syms J., Hale A. Effect of red wine ingestion on the antioxidant capacity of serum. Clin Chem. 1995 Jan;41(1):32–35. [PubMed] [Google Scholar]
  39. Willett W. C., Sampson L., Stampfer M. J., Rosner B., Bain C., Witschi J., Hennekens C. H., Speizer F. E. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985 Jul;122(1):51–65. doi: 10.1093/oxfordjournals.aje.a114086. [DOI] [PubMed] [Google Scholar]
  40. Willett W., Stampfer M. J. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol. 1986 Jul;124(1):17–27. doi: 10.1093/oxfordjournals.aje.a114366. [DOI] [PubMed] [Google Scholar]
  41. Zahm S. H., Weisenburger D. D., Saal R. C., Vaught J. B., Babbitt P. A., Blair A. The role of agricultural pesticide use in the development of non-Hodgkin's lymphoma in women. Arch Environ Health. 1993 Sep-Oct;48(5):353–358. doi: 10.1080/00039896.1993.9936725. [DOI] [PubMed] [Google Scholar]

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