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Sun exposure may protect against non-Hodgkin lymphoma: a case-control study

Hughes, A.M., Armstrong, B.K., Vajdic, C.M., Turner, J., Grulich, A.E., Fritschi, L., Milliken, S., Kaldor, J., Benke, G. and Kricker, A. (2004) Sun exposure may protect against non-Hodgkin lymphoma: a case-control study. International Journal of Cancer, 112 ( 5). pp. 865-871. ISSN 0020-7136

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Ultraviolet radiation is a hypothesised risk factor for non-Hodgkin lymphoma (NHL) but no epidemiological study has examined this association using direct measures of sun exposure in individuals. Adults aged 20-74 years living in NSW and ACT, Australia, were the study population. Cases (704 of 829 invited to take part, 85%) were diagnosed January 2000 to August 2001. Controls (694 of 1,136 invited to take part, 61%) were randomly selected from state electoral rolls and frequency-matched to cases by age, sex and state of residence. A self-administered questionnaire and telephone interview measured outdoor hours on working and nonworking days and vacations at 10, 20, 30, 40, 50 and 60 years of age. Logistic regression models of NHL and sun exposure contained the 3 matching variables, ethnicity and sun sensitivity measures as covariates. Contrary to expectations, risk of NHL fell with increasing reported sun exposure hours. Relative to 1.0 for the lowest quarter of total sun exposure hours, the odds ratios (ORs) for successively higher quarters were 0.72 (95% CI 0.53-0.98), 0.66 (0.48-0.91) and 0.65 (0.46-0.91) (ptrend=0.01). The association of sun exposure on nonworking days with NHL was stronger; OR for highest quarter 0.47 (0.34-0.66) (ptrend=0.0001). Risk also fell with sun exposure on vacations; OR for highest quarter 0.60 (0.43-0.85) (ptrend=0.003). These associations appeared strongest in women and in childhood. There was little evident trend in risk with exposure on working day. Our results provide strong statistical evidence for an inverse association between sun exposure and NHL. Increasing evidence that vitamin D may protect against cancer makes UV-mediated synthesis of vitamin D a plausible mechanism whereby sun exposure might protect against

Item Type: Article
Keywords: non-Hodgkin lymphoma • aetiology • sun exposure • UV radiation • case-control study
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 30 Jun 2009 15:17
Last Modified: 30 Jun 2009 15:17
Published Version: http://dx.doi.org/10.1002/ijc.20470
Status: Published
Publisher: John Wiley & Sons, Ltd
Refereed: Yes
Identification Number: 10.1002/ijc.20470
URI: http://eprints.whiterose.ac.uk/id/eprint/6337

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