Table 1.
Characteristics of included studies according to report type
| Authors, year, gender | Study Region | Case number Controls or cohort values | Median age, years (SD) | Lymphoma subtype | Physical activity domain, timing, definition of high vs. low PA | RR/OR/HR (95% CI), high vs. low PA | Adjustment Factors |
|---|---|---|---|---|---|---|---|
| Cohort Studies | |||||||
| Barberio et al., 2018 [17] Men and women combined | Canada (North America) | 91 (NHL) 285,787 person-years follow up | M: 57.8 (8.2) W: 55.9 (9.0) *all cancer cases | NHL | Total, recent (201.2–535.3 vs. 0–113.7 MET hours/wk) | HR 0.73 (0.40–1.36) | Age, sex, ethnicity (white/other), marital status, education level, total household income, geographic area of residence (urban/rural), smoking status, mean alcohol intake (g/d), mean energy intake (kCal/day), self-reported BMI, history of cardiovascular or respiratory condition, family history of cancer (breast or endometrial if female), other PA |
| Recreational, recent (35–255.3 vs. 0–7.4 MET hours/wk) | HR 0.86 (0.45–1.65) | ||||||
| Occupational, recent (116.8–463.4 vs. 0–34.6 MET hours/wk) | HR 0.68 (0.35–1.31) | ||||||
| Cerhan et al., 2002 [22] Women | USA (North America) | 261 (NHL) 137 (DLBCL) 58 (FL) 37,932 cohort 449,801 person years of follow up | 61.7 (no SD reported) | NHL DLBCL FL | Recreational, recent (High vs. low) | NHL: RR 0.84 (0.62–1.15) | Age |
| DLBCL: RR 1.0 (0.66–1.52) | |||||||
| FL: RR 0.58 (0.29–0.18) | |||||||
| Kabat et al., 2012 [23] Women | USA (North America) | 1123 (NHL) 302 (DLBCL) 214 (FL) 298 (CLL/SLL) 157,852 cohort | Cases: 65.2 (6.9) Non-cases 63.2 (7.2) | NHL DLBCL FL CLL/SLL | Recreational, recent (≥17.5 vs. < 1.6 MET hours/wk) | NHL: HR 1.17 (0.98–1.39) | Age (continuous), alcohol intake, smoking (pack-years), caloric intake, education level, race/ethnicity, BMI, enrollment in OS/treatment arm assignment |
| DLBCL: HR 1.03 (0.73–1.45) | |||||||
| FL: HR 1.22 (0.83–1.80) | |||||||
|
CLL/SLL: HR 1.18 (0.84–1.66) | |||||||
| Lim et al., 2007 [24] Men and women combined | USA (North America) | 1381 (NHL) 58 (HL) 472,545 non-cases | 60.9–62.5 depending on covariate classification | NHL DLBCL FL CLL/SLL T cell HL | Recreational, recent (NHL ≥5 vs. < 1x/wk.; HL 3- ≥ 5 vs. < 1/wk. activities ≥20 min with increased heart rate and sweating) | NHL: RR 0.97 (0.81–1.16) | Age, race, education, BMI, caloric intake |
| DLBCL: RR 0.87 (0.61–1.25) | |||||||
| FL: RR 0.96 (0.63–1.46) | |||||||
| CLL/SLL: RR 0.80 (0.51–1.25) | |||||||
| T-cell: RR 1.25 (0.62–2.49) | |||||||
| HL: RR 1.60 (0.72–3.54) | |||||||
| Lu et al., 2009 [25] Women | USA (North America) | 574 (NHL) 155 (DLBCL) 121 (FL) 124 (CLL/SLL) 120,642 cohort | Cohort entry: 52.7 Diagnosis: 69.5 | NHL DLBCL FL CLL/SLL | Recreational, lifetime | NHL: RR 1.00 (0.78–1.29) | Height, weight at cohort entry, age at menarche; recent PA also adjusted for long-term strenuous and moderate exercise |
| DLBCL: RR 0.97 (0.60–1.55) | |||||||
| FL: RR 1.29 (0.69–2.41) | |||||||
| CLL/SLL: RR 0.94 (0.55–1.60) | |||||||
| Recreational, Recent (≥4 vs. 0–0.5 h/wk./year of strenuous activity) | NHL: RR 1.11 (0.86–1.44) | ||||||
| DLBCL: RR 1.00 (0.62–1.62) | |||||||
| FL: RR 1.01 (0.57–1.79) | |||||||
| CLL/SLL: RR 1.50 (0.86–2.63) | |||||||
| Pukkala et al., 2000 [26] Men | Finland (Europe) | 6 (NHL) 3 (HL) 53,501 person years follow up | Modal age category 45–59 years | NHL HL | Recreational, lifetime (Athletes vs. Finnish population) | NHL: SIR 0.78 (0.29–1.70) | None |
| HL: SIR 1.33 (0.27–3.88) | |||||||
| Teras et al., 2012 [27] Men Women | USA (North America) | 2002 (NHL) 435 (DLBCL) 280 (FL) 482 (CLL/SLL) 326 (B-NHL) 110 (T-NHL) 26 (NHL NOS) 184,190 cohort | 62.9 (6.4) | NHL DLBCL FL, CLL/SLL B-NHL T-NHL NHL NOS | Recreational, recent (≥17.5 vs. 0 MET hours/wk) | NHL- M: HR 1.02 (0.82–1.26) W: HR 0.69 (0.54–0.89) | Age at baseline, family history of hematopoietic cancer, education, smoking status, alcohol intake, height, BMI, sitting time |
| DLBCL- M: HR 1.14 (0.70–1.88) W: HR 0.71 (0.44–1.16) | |||||||
| CLL/SLL-M: HR 0.95 (0.62–1.46) W: HR 0.73 (0.44–1.20) | |||||||
| FL- M: HR 0.86 (0.49–1.51) W: HR 0.77 (0.41–1.43) | |||||||
| Van Veldhoven et al., 2011 [28] Men Women Men and women combined | Europe | 778 (NHL) 94 (DLBCL) 98 (FL) 142 (B-CLL) 109 (B-NOS) 521,457 cohort | Age at recruitment: 52.9 (9.8) men, 51.0 (10.9) women | NHL DLBCL FL B-CLL B-NOS | Total, recent (Active vs. inactive) | NHL- M: HR 0.83 (0.31–2.24) W: HR 1.50 (0.45–5) | Hypertension, hyperlipidemia, education, diabetes; age and centre stratified *No adjustment for subtypes of NHL |
| DLBCL- M: HR 2.03 (0.38–10.79) W: HR 5.03 (1.19–21.33) | |||||||
| FL- M: HR 2.82 (0.52–15.23) W: HR 2.59 (0.54–12.38) | |||||||
| B-CLL- M: HR 0.76 (0.23–2.53) W: HR 10.95 (1.55–77.48) | |||||||
| B-NOS- M: HR 0.16 (0.01–1.95) W: HR 1.60 (0.20–12.52) | |||||||
| Occupational, recent (Manual/heavy labor vs. sedentary) | NHL- M: HR 1.05 (0.46–2.41) W: HR 2.06 (0.65–6.51) | ||||||
| Recreational, recent (≥45.75 vs. < 14.25 MET hours/wk) | NHL- M: HR 1.11 (0.49–2.52) W: HR 1.25 (0.49–3.16) | ||||||
| Walter et al., 2013 [18] Men and women combined | USA (North America) | 441 (Mature B cell) 104 (CLL) 257 (Other mature B cell) 22 (HL) 65,322 cohort | 61.5 (7.4) | Mature B cell neoplasms (including plasma cell disorders) CLL Other mature B cell | Recreational, lifetime (> 4.8 vs. 0.2–1.8 MET hours/wk) | *not reported for mature B cell | Age, sex, race/ethnicity, education, smoking, BMI at baseline, fatigue/lack of energy, self reported health, daily fruit consumption, daily vegetable consumption, history of anemia in year before baseline, family history of leukemia or lymphoma |
| CLL: HR 0.52 (0.26–1.03) | |||||||
| Other mature B cell: HR 0.80 (0.53–1.22) | |||||||
| Case- Control Studies | |||||||
| Boyle et al., 2015 [15] Men Women Men and women combined | Canada (North America) | 749 (NHL) 202 (DLBCL) 188 (FL) 268 (Other B cell) 70 (T cell) 818 controls | Modal age category 70+ years (cases), 60–69 years (controls) | NHL DLBCL FL Other B cell T cell | Total non-occupational, lifetime (≥85 vs. 0–35.9 MET hours/wk) | NHL- M/W: OR 1.16 (0.87–1.55) M: OR 1.14 (0.78–1.68) W: OR 1.07 (0.68–1.68) | Age group, sex, residential location, ethnicity |
| DLBCL: OR 1.22 (0.79–1.88) | |||||||
| FL: OR 1.26 (0.80–1.99) | |||||||
| Other B cell: OR 1.04 (0.69–1.57) | |||||||
| T cell: OR 1.19 (0.61–2.32) | |||||||
| Brownson et al., 1991 [29] Men | USA (North America) | 536 (NHL) 16,611 controls | Not reported | NHL | Occupational, recent (> 80% vs. < 20% active at work) | OR 0.83 (0.56–1.25) | Age, smoking |
| Cerhan et al., 2005 [30] Men and women combined | USA (North America) | 562 (NHL) 32 (DLBCL) 24 (FL) 468 controls* *Population with PA data (Total cases 1321, controls 1057 in study) | Cases: 56.1 years (12.9) Controls: 59.7 years (11.7) | NHL DLBCL FL | Occupational, lifetime (Mostly exercise vs. mostly sit at work) | NHL: OR 0.98 (0.55–1.74) | Age, sex, race and study center, BMI, height |
| DLBCL: OR 1.32 (0.63–2.76) | |||||||
| FL: OR 1.04 (0.45–2.37) | |||||||
| Non-occupational, lifetime (> 1080 vs. 0 MET hours/wk) | NHL: OR 0.83 (0.50–1.38) | ||||||
| DLBCL: OR 0.82 (0.41–1.66) | |||||||
| FL: OR 0.85 (0.39–1.83) | |||||||
| Etter et al., 2018 [16] Men Women | USA (North America) | 236 (NHL) 87 (HL) Controls 952 (NHL); 348 (HL) | NHL: 56.31 (15.42) | NHL HL | Recreational, lifetime (≥1 vs. < 1 exercise session/wk) | NHL: OR 0.74 (0.55–0.99) | Age, sex, BMI, family history of lymphoma, smoking (pack-years), education level (HL only) |
| HL: 32.90 (10.59) | HL: OR 0.53 (0.32–0.87) | ||||||
| Keegan et al., 2006 [31] Women | USA (North America) | 312 (HL) 325 controls | 35 (SD not reported) | HL | Recreational, lifetime | 19–44 years: OR 0.71 (0.48–1.05) | Age, race/ethnicity, educational level, Jewish upbringing, smoking status 1 year before diagnosis/interview, nursed children, number of miscarriages, having a first or second degree relative hx of lymphoma, Jewish heritage, single room at age 11, living in a single family home at age 8 years, living in a rented family home at age 8 years |
| 45–79 years: OR 0.35 (0.09–1.36) | |||||||
| Recreational, recent (≥2 vs. < 2 strenuous activities/wk. for > 1 month) | 19–44 years: OR 0.58 (0.39–0.87) | ||||||
| 45–79 years: OR 0.45 (0.19–1.06) | |||||||
| Kelly et al., 2012 [32] Men Women Men and women combined | USA (North America) | 950 (NHL) 181 (DLBCL) 242 (FL) 302 (CLL/SLL) 1146 controls | 63 (SD not reported) | NHL FL CLL/SLL DLBCL | Recreational, recent (> 45 vs. 1.08 MET hours/wk) *also reported recreational, early adulthood (not listed) | NHL: M/W- OR 1.03 (0.80–1.33) M- OR 1.37 (0.98–1.92) W- OR 0.71 (0.47–1.07) | Age at enrollment, gender and county of residence |
| DLBCL: M/W- OR 0.99 (0.62–1.59) M- OR 1.19 (0.64–2.21) W- OR 0.80 (0.38–1.69) | |||||||
| FL: M/W- OR 0.98 (0.65–1.48) M- OR 0.96 (0.53–1.72) W- OR 0.90 (0.49–1.67) | |||||||
|
CLL: M/W- OR 1.09 (0.75–1.58) M- OR 1.71 (1.08–2.70) W- OR 0.53 (0.27–1.06) | |||||||
|
Pan et al., 2005 [33] Men Women Men and women combined |
Canada (North America) |
1030 (NHL) 419 (DLBCL) 242 (FL) 100 (SLL) 269 (NHL NOS) 3106 controls |
Men- Cases: 56.7 (12.5) Controls: 57.9 (14.6) |
NHL DLBCL FL SLL NHL Not otherwise specified (NOS) |
Recreational, recent (≥34.4 vs. < 6.3 MET hours/wk) |
NHL: M- OR 0.79 (0.59–1.05) W- OR 0.59 (0.42–0.81) |
Age, province of residence, education, alcohol consumption, pack-years of smoking, total calorie intake, self-reported exposure to some chemicals, ever employment in some occupations, BMI, total calorie intake |
|
Women- Cases: 57.1 (12.6) 56.2 (12.2) |
DLBCL: OR 0.84 (0.62–1.13) | ||||||
| FL: OR 0.64 (0.42–0.97) | |||||||
| SLL: OR 0.74 (0.41–1.33) | |||||||
| NHL NOS: OR 0.64 (0.45–0.92) | |||||||
|
Parent et al., 2011 [34] Men |
Canada (North America) |
215 (NHL) 54 (HL) 533 controls |
Cases: 58.9 (8.01) Controls: 59.6 (7.91) |
NHL HL |
Occupational, recent (≥75% active vs. ≥75% sedentary at work) |
NHL: OR 0.56 (0.26–1.20) HL: OR 0.84 (0.17–4.23) |
Age, ethnicity, educational level, socioeconomic status, respondent status, BMI, smoking, other PA |
|
Recreational, recent (≥1 vs. <1x/wk. sports or activity) |
NHL: OR 1.17 (0.81–1.69) HL: OR 0.97 (0.45–2.08) |
||||||
|
Overall, recent (Intermediate activity at work + recreational PA or high PA at work vs. other) |
NHL: OR 0.85 (0.60–1.21) HL: OR 1.20 (0.58–2.47) |
||||||
|
Zahm et al., 1999 [35] Men Women |
USA (North America) |
1177 (NHL) 3625 control |
Median not reported. Modal age category 45–84 years (cases), 75+ years (1162 controls) |
NHL |
Occupational, lifetime or “usual” occupation (M > 12 vs. < 8; W > 8 vs. < 5 k Joules/min) |
M: OR 1.0 (0.7–1.3) W: OR 1.7 (0.2–11.5) |
Age, state of residence |
**PA Physical activity, M Men, W Women, M/W Men/Women Combined, NHL Non-Hodgkin lymphoma, DLBCL Diffuse large B cell lymphoma, FL Follicular lymphoma, CLL/SLL Chronic lymphocytic leukemia/small lymphocytic lymphoma, NOS Not otherwise specified, HL Hodgkin lymphoma, BMI Body mass index