Risk factors for non-Hodgkin's lymphoma according to family history of haematolymphoproliferative malignancies

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Abstract
Background Aetiological profiles of non-Hodgkin's lymphoma (NHL) may differ depending upon whether the disease is inheritance-related or sporadic. Because familial risk (a probable surrogate of inheritance-relatedness) of NHL is influenced by haematolymphoproliferative malignancies (HLPM), we evaluated whether non-familial risk factors differ between NHL with and without a family history of HLPM, using the Selected Cancers Study data. Methods Cases were 1511 men aged 31–59 and diagnosed with NHL during 1984–1988. Controls were men without NHL, frequency-matched to cases by age range and cancer registry (n = 1910). These groups were compared: cases with a family history of HLPM and without, and controls without such a family history. Results Polytomous logistic regression analyses showed that the odds ratio (OR) estimates of homosexual behaviour were 18.2 (95% confidence interval (CI) : 4.8–69.4) and 5.6 (95% CI : 3.3–9.5) for NHL with and without a family history of HLPM, respectively. The corresponding estimates were 3.9 (95% CI : 1.7–8.9) and 2.2 (95% CI : 1.5–3.1) for history of enlarged lymph nodes. Variables only related to NHL with a family history were use of heroin (OR = 15.6, 95% CI : 3.4–70.4), exposure to a chlorinated hydrocarbon pesticide (OR = 2.3, 95% CI : 1.0–5.0), occupational exposure to plywood, fibreboard or particleboard (OR = 2.0, 95% CI : 1.2–3.4) and history of liver diseases (other than hepatitis or cirrhosis) (OR = 6.5, 95% CI : 1.2–36.2). The association between homosexual behaviour and NHL among men with a family history was stronger for those aged 31–44, especially for B-cell type of the disease. Conclusions This study suggests differences in the risk factor profiles between NHL with and without a family history of HLPM. The higher risks of NHL for homosexual behaviour and heroin use, surrogates of HIV infection, in men with a family history of HLPM imply that genetic susceptibility may be influential on the occurrence of HIV-related NHL.

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