%0 Journal Article
%T Current Understanding of Lifestyle and Environmental Factors and Risk of Non-Hodgkin Lymphoma: An Epidemiological Update
%A Bryan A. Bassig
%A Qing Lan
%A Nathaniel Rothman
%A Yawei Zhang
%A Tongzhang Zheng
%J Journal of Cancer Epidemiology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/978930
%X The incidence rates of non-Hodgkin lymphoma (NHL) have steadily increased over the last several decades in the United States, and the temporal trends in incidence can only be partially explained by the HIV epidemic. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an ˇ°emerging epidemicˇ± of NHL and emphasized the need to investigate the factors responsible for the increasing incidence of this disease. Over the past two decades, numerous epidemiological studies have examined the risk factors for NHL, particularly for putative environmental and lifestyle risk factors, and international consortia have been established in order to investigate rare exposures and NHL subtype-specific associations. While few consistent risk factors for NHL aside from immunosuppression and certain infectious agents have emerged, suggestive associations with several lifestyle and environmental factors have been reported in epidemiologic studies. Further, increasing evidence has suggested that the effects of these and other exposures may be limited to or stronger for particular NHL subtypes. This paper examines the progress that has been made over the last twenty years in elucidating the etiology of NHL, with a primary emphasis on lifestyle factors and environmental exposures. 1. Introduction Non-Hodgkin lymphoma (NHL) is a heterogeneous disease resulting from the malignant transformation of lymphocytes and includes multiple subtypes each with specific molecular and clinical characteristics [1]. The past several decades have seen a steady increase in incidence rates of NHL, with overall rates in the United States nearly doubling over the period 1975 to 2008 (Figure 1). Currently, incidence rates of NHL for both men and women in the United States are among the highest in the world (Figure 2) and, whereas rates of NHL associated with HIV infection have decreased with the use of antiretroviral therapy, there is evidence to suggest that rates from other causes have continued to increase [2, 3]. In particular, distinct incidence trends have been reported among different demographic groups, as incidence rates decreased in middle-aged men starting in the mid 1990s, but increased in middle-aged women, blacks ˇÝ55 years old, and in younger whites aged 15¨C24 [4]. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an ˇ°emerging epidemicˇ± of NHL and the panel recommended investigation of the potential risk factors that were responsible for the rapid increase in
%U http://www.hindawi.com/journals/jce/2012/978930/