Abstract
Background: Endogenous sex hormones, particularly estrogens, modulate the immune system, and non-Hodgkin lymphoma (NHL) is a tumor that is related to immunologic status. Methods: Self-reported menstrual and reproductive history and risk of NHL were evaluated in a cohort of 37,934 Iowa women who were aged 55–69 years when first enrolled in 1986. Through 1998, 261 cases of NHL were identified by linkage to the Iowa SEER Cancer Registry. Results: After multivariate adjustment there was no association between NHL incidence and age at menarche, age at menopause, type of menopause, history of infertility, number of miscarriages, or history of induced abortion, while there were suggestive inverse associations with nulliparity (RR = 0.65; 95% CI 0.36–1.16) and years of ovulation (RR = 0.76 for ≥37 compared to <28 ovulatory years; p-trend = 0.07). Among parous women there was no association with number of livebirths or age at first livebirth, but there was an inverse association with number of children who were breast-fed (RR = 0.52 for breast-feeding >2 children versus none; 95% CI 0.33–0.82). Conclusions: Overall, menstrual and reproductive factors were not strongly related to NHL incidence. The inverse association with breast-feeding is novel but requires confirmation in other studies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Devesa SS, Fears T (1992) Non-Hodgkin's lymphoma time trends: United States and international data. Cancer Res (Suppl.) 52: 5432s-5440s.
Hoover RN (1992) Lymphoma risks in populations with altered immunity-a search for a mechanism. Cancer Res 52 (19 Suppl.): 5477s-5478s.
Ries LAG, Kosary CL, Hankey BF, Miller BA, Clegg LX (1999) SEER Cancer Statistics Review, 1973–1996. Bethesda, MD: National Cancer Institute; NIH Publ. No. 99–2789.
Olsen NJ, Kovacs WJ (1996) Gonadal steroids and immunity. Endocrine Rev 17: 369–384.
Wegmann TG, Lin H, Guilbert L, Mosmann TR (1993) Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? [See comments]. Immunol Today 14: 353–356.
Whitacre CC, Reingold SC, O'Looney PA (1999) A gender gap in autoimmunity. Science 283: 1277–1278.
Brown ZA, Vontver LA, Benedetti J, et al. (1985) Genital herpes in pregnancy: risk factors associated with recurrences and asymptomatic viral shedding. Am J Obstet Gynecol 153: 24–30.
Sakamoto K, Greally J, Gilfillan RF, et al. (1982) Epstein-Barr virus in normal pregnant women. Am J Reprod Immunol 2: 217–221.
Bruce-Chwatt LJ (1983) Malaria and pregnancy [Editorial]. BMJ (Clin Res Ed) 286: 1457–1458.
Olsson H, Landin Olsson M, Ranstam J (1990) Late age at first full-term pregnancy as a risk factor for women with malignant lymphoma. Neoplasma 37: 185–190.
Tavani A, Pregnolato A, La Vecchia C, Franceschi S (1997) A case-control study of reproductive factors and risk of lymphomas and myelomas. Leuk Res 21: 885–888.
Miller AB, Barclay TH, Choi NW, et al. (1980) A study of cancer, parity and age at first pregnancy. J Chron Dis 33: 595–605.
Frisch M, Wohlfahrt J, Westergaard T, Hjalgrim H, Melbye M (1997) Induced abortions and the risk of non-Hodgkin's lymphoma. Int J Cancer 71: 127–128.
Adami H-O, Tsaih S-W, Lambe M, et al. (1997) Pregnancy and risk of non-Hodgkin's lymphoma: a prospective study. Int J Cancer 70: 155–158.
Chiu BC, Cerhan JR, Folsom AR, et al. (1996) Diet and risk of non-Hodgkin lymphoma in older women [See comments]. JAMA 275: 1315–1321.
Cerhan JR, Wallace RB, Folsom AR, et al. (1997) Medical history risk factors for non-Hodgkin's lymphoma in older women [See comments]. J Natl Cancer Inst 89: 314–318.
Folsom AR, Kaye SA, Prineas RJ, Potter JD, Gapstur SM, Wallace RB (1990) Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol 131: 794–803.
Bisgard KM, Folsom AR, Hong CP, Sellers TA (1994) Mortality and cancer rates in nonrespondents to a prospective cohort study of older women: 5–year follow-up. Am J Epidemiol 139: 990–1000.
Percy C, Van Holten V, Muir C (1990) International Classification of Diseases for Oncology, 2nd edn. Geneva: World Health Organization.
Cox DR (1972) Regression models and life tables (with discussion). J R Stat Soc B 34: 187–220.
Folsom AR, Zhang S, Sellers TA, Zheng W, Kushi LH, Cerhan JR (1996) Cancer incidence among women living on farms: findings from the Iowa Women's Health Study. J Occup Environ Med 38: 1171–1176.
Chiu BC, Cerhan JR, Gapstur SM, et al. (1999) Alcohol consumption and non-Hodgkin lymphoma in a cohort of older women. Br J Cancer 80: 1476–1482.
Parker AS, Cerhan JR, Dick F, et al. (2000) Smoking and risk of non-Hodgkin's lymphoma subtypes in a cohort of older Iowa women. Leuk Lymph 37: 341–349.
Sellers TA, Mink PJ, Cerhan JR, et al. (1997) The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer [See comments]. Ann Intern Med 127: 973–980.
Lipworth L, Bailey LR, Trichopoulos D (2000) History of breastfeeding in relation to breast cancer risk: a review of the epidemiologic literature [See comments]. J Natl Cancer Inst 92: 302–312.
Kooijman R, Hooghe-Peters EL, Hooghe R (1996) Prolactin, growth hormone, and insulin-like growth factor-I in the immune system. Adv Immunol 63: 377–454.
Musey VC, Collins DC, Musey PI, Martino-Saltzman D, Preedy JR (1987) Long-term effect of a first pregnancy on the secretion of prolactin. N Engl J Med 316: 229–234.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cerhan, J.R., Habermann, T.M., Vachon, C.M. et al. Menstrual and reproductive factors and risk of non-Hodgkin lymphoma: the Iowa Women's Health Study (United States). Cancer Causes Control 13, 131–136 (2002). https://doi.org/10.1023/A:1014354105164
Issue Date:
DOI: https://doi.org/10.1023/A:1014354105164