Non-Hodgkin's Lymphoma and Type of Tobacco Smoke Emanuele Stagnaro1, Rosario Tumino2, Stefano Parodi3, Paolo Crosignani4, Arabella Fontana5, Giovanna Masala6, Lucia Miligi6, Oriana Nanni7, Valerio Ramazzotti8, Stefania Rodella9, Adele Senoiri Constantini6, Clotilde Vigano4, Carla Vindigni10 and Paolo Vineis11 1 Department of Environmental Epidemiology, National Cancer Research Institute, Genoa, Italy; 2 Cancer Registry, Ragusa, Italy; 3 Epidemiology and Biostatistics Department, Scientific Directorate, Gaslini Children's Hospital, Genoa, Italy; 4 Epidemiology Unit, National Cancer Research Institute, Milan, Italy; 5 Local Health Unit, Novara, Italy; 6 Center for Study and Prevention of Cancer, Scientific Institute of Tuscany, Florence Italy; 7 Cancer Institute of Romagna, Forli, Italy; 8 National Cancer Institute Regina Elena, Rome, Italy; 9 Osservatorio di Qualità, Agenzia Regionale di Sanita Toscana, Firenze, Italy; 10 Pathology Institute, University of Siena, Siena, Italy; and 11 Cancer Epidemiology Unit, University of Turin, Turin, Italy Requests for reprints: Emanuele Stagnaro, Department of Environmental Epidemiology, National Cancer Research Institute, Largo Rosanna Benzi, 10, 16132 Genoa, Italy. Phone: 39-10-5600958; Fax: 39-10-5600501. E-mail: emanuele.stagnaro@istge.it Background: In recent decades, the incidence of non-Hodgkin's lymphoma (NHL) has increased in all industrialized countries. Tobacco smoke contains several recognized or putative carcinogenic compounds that differ in concentration depending on which of the two main types, blond or black, is consumed. This investigation sought to evaluate the association between NHL and type of tobacco smoked (blond, black, or mixed), focusing on the Working Formulation (WF) subgroups. Methods: Reanalysis of Italian data from a recent multicenter population-based case-control study. The 1450 cases of NHL and 1779 healthy controls from 11 Italian areas with different demographic and productive characteristics were included in the study, corresponding to 7 million residents. Odds ratios (ORs) adjusted for age, gender, residence area, educational level, and type of interview were estimated by unconditional logistic regression model. Results: A statistically significant association [OR = 1.4, 95% confidence interval (CI) 1.1–1.7] was found for blond tobacco exposure and NHL risk. A dose-response relationship was limited to men younger than 52 years (2 for trend = 9.95, P < 0.001). Subjects starting smoking at an early age showed a higher risk in men younger than 65 years, whereas no clear trend was evident for the other age and gender subgroups. The analysis by WF categories showed the highest risks for follicular lymphoma in blond (OR = 2.1, 95% CI 1.4–3.2) and mixed (OR = 1.8, 95% CI 1.1–3.0) tobacco smokers and for large cell within the other WF group (OR = 1.6, 95% CI 1.1–2.4) only for blond tobacco. Conclusion: Smoking blond tobacco could be a risk factor for NHL, especially follicular lymphoma. Cancer Epidemiology Biomarkers & Prevention Vol. 13, 431-437, March 2004 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.