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Sunlight exposure, vitamin D, and risk of non-Hodgkin lymphoma in the Nurses’ Health Study

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Abstract

Purpose

Case–control studies suggest increased sun exposure reduces non-Hodgkin lymphoma (NHL) risk. Evidence from prospective cohort studies, however, is limited and inconsistent. We evaluated the association between ambient ultraviolet radiation (UV) exposure and NHL in a nationwide cohort of women, the Nurses’ Health Study (NHS).

Methods

Between 1976 and 2006, we identified 1064 incident NHL cases among 115,482 women in the prospective NHS. Exposures assessed included average annual UV-B flux based on residence at various times during life, vitamin D intake, and predicted plasma 25-hydroxyvitamin D levels. We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) for risk of all NHL and histologic subtypes using Cox proportional hazards models.

Results

NHL risk was increased for women residing in areas of high ambient UV radiation (UV-B flux >113 R–B count × 10−4) compared to those with lower exposure (<113), with positive linear trends at all time points. The multivariable-adjusted RR for high UV area at age 15 was 1.21 (95% CI: 1.00, 1.47; p-trend < 0.01). There was no evidence of statistical heterogeneity by subtype, although power was limited for subtype analyses. We observed no association between vitamin D measures and risk of NHL overall or by subtype.

Conclusions

Our findings do not support the hypothesis of a protective effect of UV radiation exposure on NHL risk. We found no association between vitamin D and NHL risk.

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Acknowledgments

This work was supported by the National Institutes of Health (CA87969 and CA098122). K.A.B. was supported by the Training Program in Environmental Health Sciences (T32 ES007155) and the Nutritional Epidemiology of Cancer Education and Career Development Program (R25 CA098566).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Kimberly A. Bertrand, Donna Spiegelman & Francine Laden

  2. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Kimberly A. Bertrand, Abrar A. Qureshi & Francine Laden

  3. Cancer Prevention Institute of California, Fremont, CA, USA

    Ellen T. Chang

  4. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA

    Ellen T. Chang

  5. Center for Outcomes and Policy Research, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Gregory A. Abel

  6. Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Shumin M. Zhang

  7. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Donna Spiegelman

  8. Clinical Research Program, Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Abrar A. Qureshi

  9. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

    Francine Laden

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  1. Kimberly A. Bertrand
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  2. Ellen T. Chang
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  3. Gregory A. Abel
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  4. Shumin M. Zhang
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  7. Francine Laden
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Correspondence to Kimberly A. Bertrand.

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Bertrand, K.A., Chang, E.T., Abel, G.A. et al. Sunlight exposure, vitamin D, and risk of non-Hodgkin lymphoma in the Nurses’ Health Study. Cancer Causes Control 22, 1731–1741 (2011). https://doi.org/10.1007/s10552-011-9849-x

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