Table 3.
Hazard ratios for associations between perinatal or family characteristics and non-Hodgkin lymphoma (NHL) in 1973–2009*
| Characteristic | Any NHL (N = 936) | Diffuse B-cell (N = 320) | B-cell, other or not specified (N = 170) | T-cell (N = 114) | |||||
| Unadjusted | Adjusted* | Adjusted* | Adjusted* | Adjusted* | |||||
| HR (95% CI) | HR (95% CI) | P † | HR (95% CI) | P † | HR (95% CI) | P † | HR (95% CI) | P † | |
| Sex | |||||||||
| Female | 1.00 (referent) | 1.00 (referent) | < .001 | 1.00 (referent) | < .001 | 1.00 (referent) | < .001 | 1.00 (referent) | .04 |
| Male | 1.58 (1.39 to 1.81) | 1.58 (1.38 to 1.80) | 1.61 (1.28 to 2.02) | 2.03 (1.47 to 2.81) | 1.50 (1.03, 2.19) | ||||
| Birth year | |||||||||
| 1973–1979 | 1.00 (referent) | 1.00 (referent) | .97 | 1.00 (referent) | < .001 | 1.00 (referent) | < .001 | 1.00 (referent) | < .001 |
| 1980–1984 | 1.20 (0.99 to 1.45) | 1.17 (0.97 to 1.41) | 1.14 (0.86 to 1.53) | 1.47 (0.94 to 2.28) | 1.41 (0.76 to 2.62) | ||||
| 1985–1989 | 1.01 (0.82 to 1.25) | 0.98 (0.79 to 1.21) | 0.70 (0.48 to 1.01) | 1.06 (0.61 to 1.85) | 2.42 (1.29 to 4.52) | ||||
| 1990–1994 | 0.96 (0.76 to 1.21) | 0.91 (0.72 to 1.15) | 0.29 (0.17 to 0.49) | 1.94 (1.15 to 3.26) | 4.44 (2.32 to 8.48) | ||||
| 1995–1999 | 1.14 (0.88 to 1.50) | 1.07 (0.82 to 1.41) | 0.31 (0.17 to 0.60) | 3.07 (1.61 to 5.87) | 5.33 (2.32 to 11.75) | ||||
| 2000–2004 | 1.28 (0.94 to 1.74) | 1.18 (0.86 to 1.62) | 0.44 (0.22 to 0.90) | 7.58 (3.84 to 14.97 | 5.44 (1.86 to 15.91) | ||||
| 2005–2008 | 0.77 (0.43 to 1.40) | 0.85 (0.43 to 1.68) | 0.28 (0.04 to 2.06) | NE | 7.43 (0.88 to 62.80) | ||||
| Fetal growth, SD | |||||||||
| <−2 | 0.90 (0.62 to 1.29) | 0.92 (0.64 to 1.33) | .12 | 0.69 (0.36 to 1.35) | .03 | 1.00 (0.42 to 2.34) | .66 | 0.56 (0.14 to 2.17) | .66 |
| −2 to <−1 | 0.90 (0.74 to 1.10) | 0.92 (0.75 to 1.12) | 0.79 (0.55 to 1.13) | 1.05 (0.66 to 1.66) | 0.94 (0.52 to 1.71) | ||||
| −1 to <0 | 0.99 (0.85 to 1.16) | 1.00 (0.85 to 1.17) | 0.95 (0.72 to 1.24) | 0.92 (0.64 to 1.34) | 1.06 (0.67 to 1.67) | ||||
| 0 to <1 | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | ||||
| 1 to <2 | 0.90 (0.72 to 1.14) | 0.90 (0.71 to 1.13) | 1.10 (0.76 to 1.60) | 0.62 (0.34 to 1.14) | 1.12 (0.61 to 2.06) | ||||
| ≥2 | 1.65 (1.20 to 2.26) | 1.64 (1.19 to 2.25) | 1.46 (0.82 to 2.61) | 1.73 (0.85 to 3.51) | 1.19 (0.42 to 3.36) | ||||
| Gestational age at birth, wk | |||||||||
| 22–28 | 0.72 (0.10 to 5.11) | 0.69 (0.10 to 4.94) | .30 | NE | .37 | NE | .61 | NE | .30 |
| 29–33 | 1.46 (0.86 to 2.48) | 1.41 (0.81 to 2.43) | 1.43 (0.52 to 3.90) | 0.55 (0.08 to 3.62) | 1.72 (0.39 to 7.53) | ||||
| 34–36 | 1.01 (0.73 to 1.39) | 0.98 (0.71 to 1.36) | 0.81 (0.43 to 1.53) | 1.11 (0.54 to 2.27) | 1.07 (0.42 to 2.75) | ||||
| 37–42 | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | ||||
| ≥43 | 0.69 (0.38 to 1.24) | 0.72 (0.39 to 1.31) | 1.71 (0.90 to 3.28) | NE | NE | ||||
| Multiple birth | |||||||||
| Singleton | 1.00 (referent) | 1.00 (referent) | .71 | 1.00 (referent) | .21 | 1.00 (referent) | .81 | 1.00 (referent) | .82 |
| Twin | 1.06 (0.67 to 1.69) | 1.10 (0.67 to 1.80) | 0.40 (0.10 to 1.66) | 0.87 (0.28 to 2.69) | 0.84 (0.19 to 3.71) | ||||
| Birth order | |||||||||
| 1 | 1.00 (referent) | 1.00 (referent) | .02 | 1.00 (referent) | .07 | 1.00 (referent) | .38 | 1.00 (referent) | .66 |
| 2 | 0.96 (0.83 to 1.11) | 0.90 (0.77 to 1.05) | 0.75 (0.58 to 0.98) | 0.97 (0.67 to 1.40) | 1.13 (0.72 to 1.77) | ||||
| 3 | 1.01 (0.84 to 1.22) | 0.87 (0.71 to 1.08) | 0.76 (0.53 to 1.09) | 1.06 (0.63 to 1.76) | 0.85 (0.44 to 1.63) | ||||
| 4 | 1.07 (0.78 to 1.46) | 0.88 (0.62 to 1.23) | 0.92 (0.52 to 1.61) | 0.93 (0.41 to 2.09) | 1.16 (0.49 to 2.78) | ||||
| ≥5 | 0.52 (0.27 to 1.00) | 0.41 (0.21 to 0.81) | 0.27 (0.07 to 1.11) | 0.61 (0.14 to 2.67) | NE | ||||
| Maternal age at delivery, y | |||||||||
| <20 | 1.00 (referent) | 1.00 (referent) | .004 | 1.00 (referent) | .02 | 1.00 (referent) | .32 | 1.00 (referent) | .05 |
| 20–24 | 0.94 (0.63 to 1.40) | 0.97 (0.65 to 1.44) | 1.03 (0.53 to 2.01) | 0.81 (0.35 to 1.92) | 1.24 (0.28 to 5.40) | ||||
| 25–29 | 1.01 (0.68 to 1.48) | 1.07 (0.72 to 1.59) | 1.40 (0.72 to 2.71) | 0.78 (0.33 to 1.85) | 1.49 (0.34 to 6.46) | ||||
| 30–34 | 1.09 (0.74 to 1.61) | 1.20 (0.80 to 1.81) | 1.39 (0.70 to 2.76) | 0.89 (0.36 to 2.17) | 2.21 (0.49 to 9.88) | ||||
| 35–40 | 1.32 (0.87 to 2.00) | 1.50 (0.97 to 2.33) | 1.76 (0.83 to 3.75) | 1.00 (0.38 to 2.65) | 2.62 (0.56 to 12.26) | ||||
| ≥40 | 0.86 (0.45 to 1.64) | 1.04 (0.53 to 2.02) | 1.27 (0.39 to 4.17) | 0.89 (0.21 to 3.72) | 0.94 (0.08 to 10.80) | ||||
| Maternal education, y | |||||||||
| ≤9 | 1.00 (referent) | 1.00 (referent) | .91 | 1.00 (referent) | .73 | 1.00 (referent) | .33 | 1.00 (referent) | .67 |
| 10–11 | 0.97 (0.82 to 1.16) | 0.96 (0.81 to 1.14) | 1.01 (0.75 to 1.36) | 1.23 (0.82 to 1.84) | 1.05 (0.60 to 1.84) | ||||
| 12–14 | 1.10 (0.91 to 1.32) | 1.07 (0.88 to 1.31) | 1.17 (0.83 to 1.64) | 1.28 (0.80 to 2.06) | 1.22 (0.67 to 2.25) | ||||
| ≥15 | 0.96 (0.76 to 1.21) | 0.93 (0.71 to 1.21) | 0.90 (0.56 to 1.46) | 1.34 (0.72 to 2.47) | 1.04 (0.47 to 2.31) | ||||
| Unknown | 1.01 (0.71 to 1.42) | 1.06 (0.75 to 1.50) | 1.11 (0.63 to 1.96) | 0.83 (0.32 to 2.17) | 1.71 (0.71 to 4.08) | ||||
| Paternal education, y | |||||||||
| ≤9 | 1.00 (referent) | 1.00 (referent) | .09 | 1.00 (referent) | .07 | 1.00 (referent) | 0.20 | 1.00 (referent) | .51 |
| 10–11 | 1.00 (0.85 to 1.18) | 1.00 (0.84 to 1.18) | 0.96 (0.72 to 1.27) | 1.00 (0.67 to 1.48) | 1.13 (0.69 to 1.87) | ||||
| 12–14 | 0.94 (0.78 to 1.12) | 0.89 (0.73 to 1.08) | 0.77 (0.56 to 1.06) | 0.91 (0.59 to 1.40) | 0.79 (0.44 to 1.40) | ||||
| ≥15 | 0.92 (0.74 to 1.14) | 0.85 (0.67 to 1.09) | 0.74 (0.48 to 1.14) | 0.69 (0.38 to 1.24) | 0.95 (0.47 to 1.91) | ||||
| Unknown | 0.74 (0.52 to 1.05) | 0.73 (0.51 to 1.03) | 0.37 (0.17 to 0.77) | 1.00 (0.46 to 2.16) | 0.94 (0.37 to 2.35) | ||||
| NHL in a sibling | |||||||||
| No | 1.00 (referent) | 1.00 (referent) | .001 | 1.00 (referent) | .009 | 1.00 (referent) | NE | 1.00 (referent) | NE |
| Yes | 10.03 (2.50 to 40.28) | 9.84 (2.46 to 39.41) | 13.62 (1.92 to 96.77) | NE | NE | ||||
| NHL in a parent | |||||||||
| No | 1.00 (referent) | 1.00 (referent) | .007 | 1.00 (referent) | .34 | 1.00 (referent) | 0.18 | 1.00 (referent) | .48 |
| Yes | 2.40 (1.29 to 4.49) | 2.36 (1.27 to 4.38) | 1.74 (0.56 to 5.42) | 2.64 (0.65 to 10.81) | 2.03 (0.29 to 14.31) | ||||
*
CI = confidence interval; HR = hazard ratio; NE = not estimable; SD = standard deviation. The adjusted model included sex, birth year, fetal growth, gestational age at birth, multiple birth, birth order, maternal age at delivery, maternal and paternal education level, and family history of NHL in a sibling or parent.
†
P for trend for ordered polytomous variables and Wald P for dichotomous variables, in the adjusted model. In each case where the P value for linear trend was less than .05, a separate likelihood ratio test for departure from linearity was not statistically significant (P > .05). All P values were from two-sided tests.