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Cancer Causes & Control

, 22:1731 | Cite as

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

  • Kimberly A. Bertrand
  • Ellen T. Chang
  • Gregory A. Abel
  • Shumin M. Zhang
  • Donna Spiegelman
  • Abrar A. Qureshi
  • Francine Laden
Original Paper

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.

Keywords

Non-Hodgkin lymphoma Sunlight Ultraviolet radiation Vitamin D Epidemiology 

Notes

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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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Kimberly A. Bertrand
    • 1
    • 2
  • Ellen T. Chang
    • 3
    • 4
  • Gregory A. Abel
    • 5
  • Shumin M. Zhang
    • 6
  • Donna Spiegelman
    • 1
    • 7
  • Abrar A. Qureshi
    • 2
    • 8
  • Francine Laden
    • 1
    • 2
    • 9
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.Channing Laboratory, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  3. 3.Cancer Prevention Institute of CaliforniaFremontUSA
  4. 4.Division of Epidemiology, Department of Health Research and PolicyStanford University School of MedicineStanfordUSA
  5. 5.Center for Outcomes and Policy Research, Department of Medical Oncology, Dana-Farber Cancer InstituteHarvard Medical SchoolBostonUSA
  6. 6.Division of Preventive Medicine, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  7. 7.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  8. 8.Clinical Research Program, Department of DermatologyBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  9. 9.Department of Environmental HealthHarvard School of Public HealthBostonUSA

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