Perinatal and Early-Life Exposures and Risk of Non-Hodgkin Lymphoma.
In a case-control study of 2280 NHL cases and 2253 controls, higher birth weight and childhood or growth-cessation weight were associated with greater NHL risk, while breastfeeding for more than six months was associated with lower risk, without significant heterogeneity across major NHL subtypes.
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In a case-control study of 2280 NHL cases and 2253 controls, higher birth weight and childhood or growth-cessation weight were associated with greater NHL risk, while breastfeeding for more than six months was associated with lower risk, without significant heterogeneity across major NHL subtypes.
Research significance
The evidence supports associations, not causality; it suggests the testable hypothesis that early-life adiposity-related pathways may contribute to later lymphomagenesis and that prevention research addressing childhood weight trajectories could potentially reduce NHL risk, while the breastfeeding finding requires independent confirmation before any preventive inference.
Source abstract
Background: Perinatal and early-life factors may influence non-Hodgkin lymphoma (NHL) risk, but study results have been mixed and exposure data for childhood ages are limited. Herein, we investigated associations of these exposures with risk of NHL and common subtypes. Methods: This case-control study included 2280 NHL cases and 2253 controls, enrolled from 2002 to 2014 at the Mayo Clinic Rochester. Self-reported perinatal and early-life exposures included maternal age at birth, birth order, birthweight, time breastfed, height and weight at ages 7, 12, and 18 years relative to peers, and age and weight when growth ceased. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for design variables and potential confounders. Linear trend tests were performed for ordinal variables, and heterogeneity tests were performed to evaluate whether associations varied across four NHL subtypes. Results: After multivariable adjustment, greater birth weight (OR = 1.15 for quartile 4 vs. 1; p-trend = 0.04), weight at age 7 relative to peers (compared to average, OR = 1.05 for heavy and OR = 0.87 for thin; p-trend = 0.002), and weight when growth ceased (OR = 1.30 for quartile 4 vs. 1; p-trend < 0.001) were associated with increased NHL risk. An inverse association was observed for breastfeeding duration with NHL risk (OR = 0.77 for >6 months vs. never; 95% CI 0.61-0.97). Associations did not significantly vary by major NHL subtype (p-heterogeneity > 0.05). Other perinatal and early-life exposures were not associated with NHL risk. Conclusions: Greater body weight at birth and through childhood may be associated with increased NHL risk, potentially extending the life-course perspective on adiposity and lymphomagenesis, with implications for prevention.