Abstract
A population based case-control study was conducted to determine whether risk of non-Hodgkin's lymphoma (NHL) in the absence of HIV infection is related to the previous use of tobacco, alcohol or recreational drugs. A total of 378 residents of Los Angeles County who were diagnosed with high- or intermediate-grade NHL were compared with individually age-, race- and sex-matched neighbourhood control subjects with regard to history of use of tobacco products, alcohol and ten specific recreational drugs. Risk of NHL among women decreased with increased consumption of alcoholic beverages (trend P = 0.03), with risk 50% lower among those consuming five or more drinks per week than among non-drinkers. Cocaine, amphetamines, Quaaludes and lysergic acid diethylamide (LSD) were each associated with a significantly increased risk of NHL in men with risk greater among those with more frequent use of these drugs. Confounding factors could not be excluded in these findings. The use of multiple types of drugs was also associated with a significantly increased risk of NHL in men (trend P = 0.005) with risk greatest among those using five or more types of drugs (odds ratio = 5.8, 95% confidence limits = 1.2-28.4); among these drugs, cocaine use appeared to account for the elevated risk of NHL among men based on multivariable analyses.
Highlights
Non-Hodgkin's lymphomas (NHL) are a heterogeneous group of tumours that account for approximately 3% of all cancers diagnosed in the United States (Boring et al, 1991)
Diagnosed patients with NHL living in Los Angeles County who were between the ages of 18 and 75 years at the time of diagnosis were identified by the Cancer Surveillance Program (CSP), the population-based cancer registry for Los Angeles County, using a rapid case reporting mechanism
The onset of the acquired immune deficiency syndrome (AIDS) epidemic and development of AIDS-related lymphoma has contributed to this overall increase, the incidence of lymphoma had begun to increase substantially several decades before this epidemic began
Summary
Non-Hodgkin's lymphomas (NHL) are a heterogeneous group of tumours that account for approximately 3% of all cancers diagnosed in the United States (Boring et al, 1991). Strong evidence suggests that the Epstein-Barr virus (EBV) is causally associated with the NHL occurrence under certain conditions of acquired or inherited immune suppression (Mueller et al, 1992). Other immune aberrations, such as autoimmune disorders including rheumatoid arthritis (Isomaki et al, 1979; Kinlen, 1985) and Sjorgren's syndrome (Kassam et al, 1978), have been linked to greater risk of NHL. To examine risk factors for development of NHL, we conducted a population-based case-control study in Los Angeles County. The current work focuses on the use of tobacco, alcohol, and recreational drugs as possible risk factors for the development of NHL, with results based upon the participants' histories of use of these substances
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