Abstract
We undertook this study to examine whether there exists an association between parity and age at first birth and risk of death from non-Hodgkin’s lymphoma (NHL). Our sample included a total of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We followed each subject from their first childbirth to 31 December 2009, and determined their vital status by merging natality data with Taiwan’s national death certificate database. Hazard ratios (HR) of death from NHL associated with parity and age at first birth were estimated using Cox proportional hazard regression models. In all, 412 NHL deaths were recorded during 34,980,246 person-years of follow-up. NHL mortality rate was 1.18 cases per 100,000 person-years. Older age at first birth (>23 vs. ≤23 years) was linked to an increased risk of death from NHL (adjusted HR = 1.41; 95% CI = 1.13–1.75). Controlling for age at first birth, the adjusted HR were 0.74 (95% CI = 0.55–0.98) for women with 2 births, and 0.71 (95% CI = 0.53–0.95) for women with 3 births or more, respectively, when compared with women with only 1 birth. A statistically significant downward trend in the adjusted HR for NHL death was detected with increasing parity (p for trend = 0.05). The HR of death from NHL was decreased by 7% (HR = 0.93; 95% CI = 0.87–0.99) for each additional parity. Our findings are consistent with reproductive factors (parity and early age at first birth) conferring a protective effect against the risk of NHL death.
Highlights
In Taiwan, non-Hodgkin’s lymphoma (NHL) is the 9th leading cause of cancer mortality for males and females [1]
Mortality associated with parity and maternal age at first birth, and recorded the 95% confidence intervals (CIs) for the Hazard ratios (HR)
Our analysis provides support for this hypothesis. In this prospective cohort study, we found a 1.41-fold increase in NHL mortality risk for women who had their first birth at age 23 years or later, relative to those who had their first birth before age 23 years after controlling for parity
Summary
In Taiwan, non-Hodgkin’s lymphoma (NHL) is the 9th leading cause of cancer mortality for males and females [1]. It has been shown that the incidence rates for NHL are commonly higher in men than in women [3] Aside from their role in endocrine function, sex hormones play a part in immune system regulation and could be involved in lymphomagenesis [6,7,8]. The general results are inconsistent, previous studies do indicate a possible role for selected reproductive factors, parity, in the reduction of NHL risk in women. We conducted a study on a large cohort of women who experienced a first and singleton childbirth between 1 January 1978 and 31 December 1987 and subsequent NHL mortality risk in order to better understand the association between parity, age at first birth, and the risk of death from NHL in Taiwan
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