Hepatitis C and Non-Hodgkin Lymphoma Among 4784 Cases and 6269 Controls From the International Lymphoma Epidemiology Consortium
Background & Aims: Increasing evidence points towards a role of hepatitis C virus (HCV) infection in causing malignant lymphomas. We pooled case-control study data to provide robust estimates of the risk of non-Hodgkin’s lymphoma (NHL) subtypes after HCV infection. Methods: The analysis included 7 member studies from the International Lymphoma Epidemiology Consortium (InterLymph) based in Europe, North America, and Australia. Adult cases of NHL (n = 4784) were diagnosed between 1988 and 2004 and controls (n = 6269) were matched by age, sex, and study center. All studies used third-generation enzyme-linked immunosorbent assays to test for antibodies against HCV in serum samples. Participants who were human immunodeficiency virus positive or were organ-transplant recipients were excluded. Results: HCV infection was detected in 172 NHL cases (3.60%) and in 169 (2.70%) controls (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.40–2.25). In subtype-specific analyses, HCV prevalence was associated with marginal zone lymphoma (OR, 2.47; 95% CI, 1.44–4.23), diffuse large B-cell lymphoma (OR, 2.24; 95% CI, 1.68–2.99), and lymphoplasmacytic lymphoma (OR, 2.57; 95% CI, 1.14–5.79). Notably, risk estimates were not increased for follicular lymphoma (OR, 1.02; 95% CI, 0.65–1.60). Conclusions: These results confirm the association between HCV infection and NHL and specific B-NHL subtypes (diffuse large B-cell lymphoma, marginal zone lymphoma, and lymphoplasmacytic lymphoma).
⁎Unit of Infections and Cancer, Catalan Institute of Oncology, Institut d’Investigació Biomèdica de Bellvitge, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
‡National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia
§Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
∥Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
¶Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, Canada
#Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
⁎⁎Genetic Epidemiology Group, International Agency for Research in Cancer, Lyon, France
‡‡Epidemiology and Biostatistics Unit, Aviano Cancer Centre, Aviano, Italy
§§Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
∥∥Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
¶¶Registre des Hemopathies Malignes de Cote d’Or, Faculte de Medecine de Dijon, Dijon, France
##Department of Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy
⁎⁎⁎Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
‡‡‡Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
§§§Department of Public Health, Public Health University College, Dublin, Irelandy
∥∥∥Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
Address requests for reprints to: Silvia de Sanjosé, MD, PhD, Unit of Infections and Cancer, Catalan Institut of Oncology, Institut d’Investigació Biomèdica de Bellvitge, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Gran Via km 2.7, 08907 L’Hospitalet de Llobregat, Barcelona, Spain. fax: (34) 93 2607787.
Individual studies that contributed data to this pooled analysis were supported by the following: grant CA62006 from the National Cancer Institute (Connecticut study); contracts PC65064, PC67008, PC67009, PC67010, and PC71105 from the National Cancer Institute and the National Cancer Institute Intramural Research Program (NCI-SEER study); grants CA45614, CA89745, CA87014, and CA104682 (University of California San Francisco study); the Italian Association for Cancer Research (northern and southern Italy study); grant CA51086 from the National Cancer Institute, the European Community (Europe Against Cancer Programme), and the Lega Italiana per la Lotta Contro I Tumori (Multicentre Italian Study WILL); a European Commission grant no. QLK4-CT-2000-00422 (EpiLymph studies); the Association pour la Recherche contre le Cancer (no. 5111) and the Fondation de France (1999 008471) (EpiLymph-France); the Compagnia di San Paolo di Torino, Programma Oncologia 2001 (EpiLymph-Italy); the Health Research Board (EpiLymph-Ireland); the Spanish Ministry of Health FISS grants PI040091, PI041467, and CIBERESP 06/06/0073 (EpiLymph-Spain); the German Federal Office for Radiation Protection (StSch4261 and StSch4420) (EpiLymph-Germany); and the National Cancer Institute of Canada, the Chan Sisters Foundation, and the Canadian Institutes for Health Research (British Columbia study); and project grant 990920 of the National Health and Medical Research Council of Australia (Australia study).
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