Non-Hodgkin lymphoma (NHL) is the most common hematopoietic cancer among adults in the United States. Studies conducted in Caucasian populations suggested that a higher body mass and smoking may increase risk while alcohol use may lower the risk. However, it is not known whether the same relationships exist in Asian populations for which incidence rates historically have been lower than Caucasians. Given the rising prevalence of obesity and cigarette smoking in many countries in Asia and immigrants in the US, there exists an urgent need to clarify the potential role of these modifiable factors in th NHL risk.
The aims of this research are to investigate the associations between deaths from lymphoma and body mass, smoking, and alcohol use in Asian populations. To accomplish these aims, we will conduct a cohort analysis using data from the Asia Cohort Consortium;consisting of 17 cohorts with over 870,000 participants and 686 recorded NHL deaths. Data on body mass, tobacco smoking, and alcohol use have already been harmonized. Data on NHL deaths and person time for the current proposal have also been obtained from each cohort. We will examine the association between deaths from NHL and body mass, smoking, and alcohol consumption using Cox proportional hazard regression models. A two- stage method for analysis of pooled data will be used to compare the risk estimates from fixed- effects models with those from random-effects models to assess the effect of heterogeneity. Using existing data from the Asia Cohort Consortium, the proposed study is extremely cost-effective for clarifying the relationship between body mass, smoking, and alcohol use and risk of NHL and extending findings to the Asian populations, one of the fastest growing ethnic groups in the United States.
This study will provide invaluable resources and set groundwork for future research aimed at identifying modifiable lifestyle factors for NHL risk and ultimately improve the prevention of NHL in the general population. PUBLIC HEALTH RELEVANCE: Our innovative and comprehensive assessment of body mass, smoking, and alcohol use with deaths from lymphoma among Asian populations in a pooled analysis of 17 cohort studies (>870,000 participants and 686 deaths from non-Hodgkin lymphoma) is unique to population-based research and will enable us to identify potentially modifiable exposures that are important in lymphoma risk. The established collaborative relationships among the project investigators, the use of already collected extensive epidemiological data from prospective cohorts, and the existing resources offered by the Asia Cohort Consortium ensure the achievement of the study aims and goals. Results from these analyses will clarify the role of these modifiable factors in NHL mortality and impact research in a manner that may be translated to programs to reduce NHL mortality.