Nikolaus Becker

German Cancer Research Center, Heidelburg, Baden-Württemberg, Germany

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Publications (162)683.97 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Marginal zone lymphoma (MZL), comprised of nodal, extranodal, and splenic subtypes, accounts for 5%-10% of non-Hodgkin lymphoma cases. A detailed evaluation of the independent effects of risk factors for MZL and its subtypes has not been conducted.
    Journal of the National Cancer Institute. Monographs. 08/2014; 2014(48):52-65.
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    ABSTRACT: Recent genome-wide association studies (GWAS) of Hodgkin lymphoma (HL) have identified associations with genetic variation at both HLA and non-HLA loci; however, much of heritable HL susceptibility remains unexplained. Here we perform a meta-analysis of three HL GWAS totaling 1,816 cases and 7,877 controls followed by replication in an independent set of 1,281 cases and 3,218 controls to find novel risk loci. We identify a novel variant at 19p13.3 associated with HL (rs1860661; odds ratio (OR)=0.81, 95% confidence interval (95% CI)=0.76–0.86, Pcombined=3.5 × 10^(−10)), located in intron 2 of TCF3 (also known as E2A), a regulator of B- and T-cell lineage commitment known to be involved in HL pathogenesis. This meta-analysis also notes associations between previously published loci at 2p16, 5q31, 6p31, 8q24 and 10p14 and HL subtypes. We conclude that our data suggest a link between the 19p13.3 locus, including TCF3, and HL risk.
    Nature Communications 06/2014; 5:3856. · 10.02 Impact Factor
  • N. Becker
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    ABSTRACT: Epidemiologische Krebsregister sind Einrichtungen, die das Auftreten von Krebskrankheiten in der Bevölkerung eines oder mehrerer Bundesländer in seiner zeitlichen Entwicklung und geografischen Verteilung beschreiben. Zu deren Aufgaben gehört zwangsläufig auch die Bearbeitung mutmaßlicher oder offensichtlicher regionaler Häufungen von Krebsfällen. Die auf den ersten Blick naheliegende Abfolge von Bearbeitungsschritten, a) Feststellung, ob eine Häufung vorliegt, durch einen statistischen Test, b) Suche nach möglichen regionenspezifischen Expositionen als möglichen Ursachen, c) ggf. Durchführung einer ätiologisch-epidemiologischen Studie zur Bestätigung einer vermuteten Assoziation, kann jedoch aufgrund grundsätzlicher methodischer Schwierigkeiten nicht zum Erfolg führen. In diesem Beitrag wird dargelegt, wie die Register mit der „Cluster-Problematik“ auch umgehen können. Sie sollten den Betroffenen und der Politik diese Problematik erklären, den epidemiologischen Wissensstand zur Verursachung von Krebskrankheiten zur Ausräumung von Missverständnissen hinsichtlich möglicher Ursachen regionaler Häufungen darlegen und eventuell professionelle Hilfe in Sachen Risikokommunikation durch Krebsberatungsdienste in Anspruch nehmen.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2014; 57(1). · 0.72 Impact Factor
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    ABSTRACT: To investigate the potential of MRI for lung nodule detection in a high-risk population in comparison to low-dose CT. 49 participants (31 men, 18 women, 51-71 years) of the German Lung Cancer Screening and Intervention Trial (LUSI) with a cancer-suspicious lung lesion in CT were examined with non-contrast-enhanced MRI of the lung at 1.5T. Data were pseudonymized and presented at random order together with 30 datasets (23 in men, 7 in women, 18-64 years) from healthy volunteers. Two radiologists read the data for the presence of nodules. Sensitivity and specificity were calculated. Gold standard was either histology or long-term follow-up. Contrast-to-Noise-Ratio (CNR) was measured for all detected lesions in all MRI sequences. Average maximum diameter of the lesions was 15mm. Overall sensitivity and specificity of MRI were 48% (26/54) and 88% (29/33) compared to low-dose CT. Sensitivity of MRI was significantly higher for malignant nodules (78% (12.5/16)) than for benign ones (36% (13.5/38); P=0.007). There was no statistically significant difference in sensitivity between nodules (benign and malignant) larger or smaller than 10mm (P=0.7). Inter observer agreement was 84% (κ=0.65). Lesion-to-background CNR of T2-weighted single-shot turbo-spin-echo was significantly higher for malignant nodules (89±27) than for benign ones (56±23; P=0.002). The sensitivity of MRI for detection of malignant pulmonary nodules in a high-risk population is 78%. Due to its inherent soft tissue contrast, MRI is more sensitive to malignant nodules than to benign ones. MRI may therefore represent a useful test for early detection of lung cancer.
    European journal of radiology 12/2013; · 2.65 Impact Factor
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    ABSTRACT: In this study, plasma samples from a multicentric case-control study on lymphoma were analyzed for the identification of proteins useful for diagnosis. The protein content in the plasma of 100 patients suffering from the three most common B-cell lymphomas and 100 control samples was studied with antibody microarrays composed of 810 antibodies that target cancer-associated proteins. Sample pools were screened for an identification of marker proteins. Then, the samples were analyzed individually to validate the usability of these markers. More than 200 proteins with disease-associated abundance changes were found. The evaluation on individual patients confirmed some molecules as robust informative markers while others were inadequate for this purpose. In addition, the analysis revealed distinct subgroups for each of the three investigated B-cell lymphoma subtypes. With this information, we delineated a classifier that discriminates the different lymphoma entities. Variations in plasma protein abundance permit discrimination between different patient groups. After validation on a larger study cohort, the findings could have diagnostic as well as differential diagnostic potential. Beside this, methodological aspects were critically evaluated, such as the value of sample pooling for the identification of biomarkers that are useful for a diagnosis on individual patients.
    PROTEOMICS - CLINICAL APPLICATIONS 12/2013; 7(11-12):802-12. · 1.81 Impact Factor
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    ABSTRACT: Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk but inconsistently, in few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure, and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1,320 HL cases and 6,381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used two-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but found no significant dose-response relationships. Risks were significant only for EBV-positive HL (pooled odds ratio = 0.56, 95% confidence interval = 0.35, 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (p=0.03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets.
    Blood 09/2013; · 9.78 Impact Factor
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    ABSTRACT: Recent findings suggest that alcohol consumption may reduce risk of multiple myeloma. To better understand this relationship, we conducted an analysis of six case-control studies participating in the International Multiple Myeloma Consortium (1,567 cases, 7,296 controls). Summary ORs and 95% confidence intervals (CI) relating different measures of alcohol consumption and multiple myeloma risk were computed by unconditional logistic regression with adjustment for age, race, and study center. Cases were significantly less likely than controls to report ever drinking alcohol (men: OR = 0.72; 95% CI, 0.59-0.89; women: OR = 0.81; 95% CI, 0.68-0.95). The inverse association with multiple myeloma was stronger when comparing current to never drinkers (men: OR = 0.57; 95% CI, 0.45-0.72; women: OR = 0.55; 95% CI, 0.45-0.68), but null among former drinkers. We did not observe an exposure-response relationship with increasing alcohol frequency, duration, or cumulative lifetime consumption. Additional adjustment for body mass index, education, or smoking did not affect our results; and the patterns of association were similar for each type of alcohol beverage examined. Our study is, to our knowledge, the largest of its kind to date, and our findings suggest that alcohol consumption may be associated with reduced risk of multiple myeloma. Prospective studies, especially those conducted as pooled analyses with large sample sizes, are needed to confirm our findings and further explore whether alcohol consumption provides true biologic protection against this rare, highly fatal malignancy. Cancer Epidemiol Biomarkers Prev; 1-8. ©2013 AACR.
    Cancer Epidemiology Biomarkers &amp Prevention 08/2013; · 4.56 Impact Factor
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    ABSTRACT: We evaluated the association between occupational exposure to trichloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL) in a pooled analysis of four international case-control studies. Overall, the pooled study population included 3788 NHL cases and 4279 controls. Risk of NHL and its major subtypes associated with TCE exposure was calculated with unconditional logistic regression and polytomous regression analysis, adjusting by age, gender and study. Risk of follicular lymphoma (FL), but not NHL overall or other subtypes, increased by probability (p=0.02) and intensity level (p=0.04), and with the combined analysis of four exposure metrics assumed as independent (p=0.004). After restricting the analysis to the most likely exposed study subjects, risk of NHL overall, FL and chronic lymphocytic leukaemia (CLL) were elevated and increased by duration of exposure (p=0.009, p=0.04 and p=0.01, respectively) and with the combined analysis of duration, frequency and intensity of exposure (p=0.004, p=0.015 and p=0.005, respectively). Although based on small numbers of exposed, risk of all the major NHL subtypes, namely diffuse large B-cell lymphoma, FL and CLL, showed increases in risk ranging 2-3.2-fold in the highest category of exposure intensity. No significant heterogeneity in risk was detected by major NHL subtypes or by study. Our pooled analysis apparently supports the hypothesis of an increase in risk of specific NHL subtypes associated with occupational exposure to TCE.
    Occupational and environmental medicine 07/2013; · 3.64 Impact Factor
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    ABSTRACT: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes. Through the InterLymph Consortium, 12 case-control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology and Epstein-Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls. Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01-1.21]. This increased risk reflected associations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29-1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27-2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90-1.32) and EBV-negative HL (OR = 1.02, 95% CI 0.72-1.44) was not increased. These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking should be added to the few modifiable HL risk factors identified.
    Annals of Oncology 06/2013; · 7.38 Impact Factor
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    ABSTRACT: Genome-wide association studies (GWAS) have previously identified 13 loci associated with risk of chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL). To identify additional CLL susceptibility loci, we conducted the largest meta-analysis for CLL thus far, including four GWAS with a total of 3,100 individuals with CLL (cases) and 7,667 controls. In the meta-analysis, we identified ten independent associated SNPs in nine new loci at 10q23.31 (ACTA2 or FAS (ACTA2/FAS), P = 1.22 × 10(-14)), 18q21.33 (BCL2, P = 7.76 × 10(-11)), 11p15.5 (C11orf21, P = 2.15 × 10(-10)), 4q25 (LEF1, P = 4.24 × 10(-10)), 2q33.1 (CASP10 or CASP8 (CASP10/CASP8), P = 2.50 × 10(-9)), 9p21.3 (CDKN2B-AS1, P = 1.27 × 10(-8)), 18q21.32 (PMAIP1, P = 2.51 × 10(-8)), 15q15.1 (BMF, P = 2.71 × 10(-10)) and 2p22.2 (QPCT, P = 1.68 × 10(-8)), as well as an independent signal at an established locus (2q13, ACOXL, P = 2.08 × 10(-18)). We also found evidence for two additional promising loci below genome-wide significance at 8q22.3 (ODF1, P = 5.40 × 10(-8)) and 5p15.33 (TERT, P = 1.92 × 10(-7)). Although further studies are required, the proximity of several of these loci to genes involved in apoptosis suggests a plausible underlying biological mechanism.
    Nature Genetics 06/2013; · 35.21 Impact Factor
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    ABSTRACT: OBJECTIVES: Established risk factors for leukaemia do not explain the majority of leukaemia cases. Previous studies have suggested the importance of occupation and related exposures in leukaemogenesis. We evaluated possible associations between job title and selected hazardous agents and leukaemia in the European Prospective Investigation into Cancer and Nutrition. METHODS: The mean follow-up time for 241 465 subjects was 11.20 years (SD 2.42 years). During the follow-up period, 477 incident cases of myeloid and lymphoid leukaemia occurred. Data on 52 occupations considered a priori to be at high risk of developing cancer were collected through standardised questionnaires. Occupational exposures were estimated by linking the reported occupations to a job exposure matrix. Cox proportional hazard models were used to explore the association between occupation and related exposures and risk of leukaemia. RESULTS: The risk of lymphoid leukaemia significantly increased for working in chemical laboratories (HR 8.35, 95% CI 1.58 to 44.24), while the risk of myeloid leukaemia increased for working in the shoe or other leather goods industry (HR 2.54, 95% CI 1.28 to 5.06). Exposure-specific analyses showed a non-significant increased risk of myeloid leukaemias for exposure to benzene (HR 1.15, 95% CI 0.75 to 1.40; HR=1.60, 95% CI 0.95 to 2.69 for the low and high exposure categories, respectively). This association was present both for acute and chronic myeloid leukaemia at high exposure levels. However, numbers were too small to reach statistical significance. CONCLUSIONS: Our findings suggest a possible role of occupational exposures in the development of both lymphoid and myeloid leukaemia. Exposure to benzene seemed to be associated with both acute and chronic myeloid leukaemia.
    Occupational and environmental medicine 04/2013; · 3.64 Impact Factor
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    ABSTRACT: OBJECTIVES: Allergies and asthma may be protective for the development of lymphoma. We evaluated whether occupational allergens that provoke immune reactivity and asthma through an IgE-mediated pathway are protective for lymphoma. METHODS: The Epilymph study includes histologically or cytologically confirmed Hodgkin, B-cell, and T-cell lymphoma cases from six European countries (Spain, France, Germany, Italy, Ireland, and Czech Republic) recruited in 1998-2004. Controls were frequency matched to cases by age, gender, and study centre. Lifetime occupational exposure to seven high molecular weight (HMW) agents was evaluated through an asthma-specific job-exposure matrix. 2205 lymphoma cases and 2296 controls with complete occupational history could be included in the analysis. Associations between HMW exposures and lymphoma were evaluated using pooled unconditional logistic regression analyses. RESULTS: Individuals exposed to HMW agents had a non-statistically significant decreased risk of any lymphoma (OR, 0.88: 95% CI, 0.74-1.05) and of B-cell lymphoma (OR, 0.91; 95% CI, 0.76-1.09), and a significantly decreased risk for Hodgkin lymphoma (OR, 0.62; 95% CI, 0.40-0.98). A decrease in risk for lymphoma was found for exposure to latex (OR, 0.74; 95% CI, 0.55-0.99). CONCLUSIONS: Further epidemiologic and mechanistic research is needed to confirm that occupational exposure to HMW agents predisposing to asthma can reduce the risk of lymphoma.
    Cancer epidemiology. 03/2013;
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    ABSTRACT: Objective: We investigated occupational risk of multiple myeloma (MM) in a pooled analysis of five international case-control studies. Methods: We calculated the odds ratio and its 95% confidence interval for selected occupations with unconditional regression analysis in 1959 MM cases and 6192 controls, by pooling study-specific risks using random-effects meta-analysis. Exposure to organic solvents was assessed with a job-exposure matrix (JEM). Results: Gardeners and nursery workers combined, most likely exposed to pesticides, showed a 50% increase in risk (OR=1.50, 95% CI 0.9-2.3), while other farming jobs did not. Metal processors (OR=1.55, 95% CI 0.9-2.3), female cleaners (OR=1.32, 95% CI 1.0-1.8), and high level exposure to organic solvents (OR=1.38, 95% CI 0.96-1.8) also showed moderately increased risks. Conclusions: Additional case-control studies of MM aetiology are warranted to further investigate the nature of the repeatedly reported increase in MM risk in several occupational groups.
    Cancer epidemiology. 02/2013;
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    ABSTRACT: PURPOSE: Studies of smoking and risk of non-Hodgkin lymphoma (NHL) have yielded inconsistent results, possibly due to subtype heterogeneity and/or genetic variation impacting the metabolism of tobacco-derived carcinogens, including substrates of the N-acetyltransferase enzymes NAT1 and NAT2. METHODS: We conducted a pooled analysis of 5,026 NHL cases and 4,630 controls from seven case-control studies in the international lymphoma epidemiology consortium to examine associations between smoking, variation in the N-acetyltransferase genes NAT1 and NAT2, and risk of NHL subtypes. Smoking data were harmonized across studies, and genetic variants in NAT1 and NAT2 were used to infer acetylation phenotype of the NAT1 and NAT2 enzymes, respectively. Pooled odds ratios (ORs) and 95 % confidence intervals (95 % CIs) for risk of NHL and subtypes were calculated using joint fixed effects unconditional logistic regression models. RESULTS: Current smoking was associated with a significant 30 % increased risk of follicular lymphoma (n = 1,176) but not NHL overall or other NHL subtypes. The association was similar among NAT2 slow (OR 1.36; 95 % CI 1.07-1.75) and intermediate/rapid (OR 1.27; 95 % CI 0.95-1.69) acetylators (p (interaction) = 0.82) and also did not differ by NAT1*10 allelotype. Neither NAT2 phenotype nor NAT1*10 allelotype was associated with risk of NHL overall or NHL subtypes. CONCLUSION: The current findings provide further evidence for a modest association between current smoking and follicular lymphoma risk and suggest that this association may not be influenced by variation in the N-acetyltransferase enzymes.
    Cancer Causes and Control 11/2012; · 3.20 Impact Factor
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    ABSTRACT: OBJECTIVES: We investigated the role of occupational exposure to specific groups of agrochemicals in the aetiology of lymphoma overall, B cell lymphoma and its most prevalent subtypes. METHODS: In 1998-2003, 2348 incident lymphoma cases and 2462 controls were recruited to the EPILYMPH case-control study in six European countries. A detailed occupational history was collected in cases and controls. Job modules were applied for farm work including specific questions on type of crop, farm size, pests being treated, type and schedule of pesticide use. In each study centre, industrial hygienists and occupational experts assessed exposure to specific groups of pesticides and individual compounds with the aid of agronomists. We calculated the OR and its 95% CI associated with lymphoma and the most prevalent lymphoma subtypes with unconditional logistic regression, adjusting for age, gender, education and centre. RESULTS: Risk of lymphoma overall, and B cell lymphoma was not elevated, and risk of chronic lymphocytic leukaemia (CLL) was elevated amongst those ever exposed to inorganic (OR=1.6, 95% CI 1.0 to 2.5) and organic pesticides (OR=1.5, 95% CI 1.0 to 2.1). CLL risk was highest amongst those ever exposed to organophosphates (OR=2.7, 95% CI 1.2 to 6.0). Restricting the analysis to subjects most likely exposed, no association was observed between pesticide use and risk of B cell lymphoma. CONCLUSIONS: Our results provide limited support to the hypothesis of an increase in risk of specific lymphoma subtypes associated with exposure to pesticides.
    Occupational and environmental medicine 11/2012; · 3.64 Impact Factor
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    ABSTRACT: We explored risk of lymphoma and its most prevalent subtypes associated with occupational contact with livestock, and whether risk was modified by age at first contact, in 2,348 incident lymphoma cases and 2,462 controls who participated in the EPILYMPH case-control study. A detailed occupational history was collected in cases and controls, including working in a livestock farm, species of livestock, its approximate number, and circumstances of contact. For each disease outcome, and each type of livestock, Odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated using unconditional logistic regression, adjusting for age, gender, education and centre. Lymphoma risk (all subtypes combined) was not increased amongst those exposed to contact with any livestock (OR = 1.0, 95% CI 0.8 -1.2). Overall, we did not observe an association between occupational contact with livestock and risk of lymphoma (all types) and B-cell lymphoma. The risk of DLBCL, was significantly lower amongst subjects who started occupational contact with any species of livestock before or at age 12 (OR = 0.5, 95% CI 0.2 -0.9), but not al older ages. A significant heterogeneity in risk of B cell lymphoma by age at first contact was detected for contact with cattle, poultry and swine. Early occupational contact with livestock might be associated with a decrease in risk of B cell lymphoma. © 2012 Wiley Periodicals, Inc.
    International Journal of Cancer 10/2012; · 6.20 Impact Factor
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    ABSTRACT: Many common genetic variants have been associated with non-Hodgkin lymphoma (NHL), but individual study results are often conflicting. To confirm the role of putative risk alleles in B-cell NHL etiology, we performed a validation genotyping study of 67 candidate single nucleotide polymorphisms (SNPs) within InterLymph, a large international consortium of NHL case-control studies. A meta-analysis was performed on data from 5,633 B-cell NHL cases and 7,034 controls from eight InterLymph studies. rs3789068 in the pro-apoptotic BCL2L11 gene was associated with an increased risk for B-cell NHL (OR=1.21, p-random=2.21x10(-11)) with similar risk estimates for common B-cell subtypes. PRRC2A rs3132453 in the HLA complex class III region conferred a reduced risk of B-cell NHL (OR=0.68, p-random=1.07x10(-9)) and was likewise evident for common B-cell subtypes. These results are consistent with the known biology of NHL and provide insights into shared pathogenic components, including apoptosis and immune regulation, for the major B-cell lymphoma subtypes.
    Blood 10/2012; · 9.78 Impact Factor
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    ABSTRACT: Serological analyses within epidemiological cohort and case-control studies indicate to an association between HBV infection and risk of multiple myeloma (MM). To verify the relationship with an independent approach, we investigated the correlation between HBV positivity and chromosomal aberrations within 680 patients of the National Center for Tumor Diseases Heidelberg for which the serological HBV status (HBsAg and anti-HBc) and FISH data for 5 gains (1q21, 9q34, 11q23, 15q22, 19q13), 5 losses (6q21, 8p21, 13q14, 17p13, 22q11) and 3 IgH translocations (t(4,14), t(11,14), t(14,16)) were available. Deletion of 8p21 and 13q14 were shown associated with HBV positivity within hepatocellular carcinoma in other investigations. In the present evaluation, the odds ratio for loss of 8p21 was significantly elevated (OR=2.74, 95%CL=1.36-5.50, p=0.0048) and for loss of 13q14 non-significantly increased (OR=1.40, 95%CL=0.74-2.65) in anti-HBc positive patients. The results provide further support for a role of HBV infection in the pathogenesis of MM. n(A) (bst) =149 n(tot) =2477 © 2012 John Wiley & Sons A/S.
    European Journal Of Haematology 10/2012; · 2.55 Impact Factor
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    ABSTRACT: The two most common forms of non-Hodgkin lymphoma (NHL) exhibit different sex ratios: diffuse large B-cell lymphoma (DLBCL) occurs more frequently in men and follicular lymphoma (FL) more frequently in women. Looking among women alone, this pooled analysis explores the relationship between reproductive histories and these cancers. Self-reported reproductive histories from 4263 women with NHL and 5971 women without NHL were pooled across 18 case-control studies (1983-2005) from North America, Europe and Japan. Study-specific odd ratios (ORs) and confidence intervals (CIs) were estimated using logistic regression and pooled using random-effects meta-analyses. Associations with reproductive factors were found for FL rather than NHL overall and DLBCL. In particular, the risk of FL decreased with increasing number of pregnancies (pooled OR(trend) = 0.88, 95% CI 0.81-0.96). FL was associated with hormonal contraception (pooled OR = 1.30, 95% CI 1.04-1.63), and risks were increased when use started after the age of 21, was used for <5 years or stopped for >20 years before diagnosis. DLBCL, on the other hand, was not associated with hormonal contraception (pooled OR = 0.87, 95% CI 0.65-1.16). Hormonal contraception is associated with an increased risk of FL but not of DLBCL or NHL overall.
    Annals of Oncology 07/2012; 23(9):2362-74. · 7.38 Impact Factor
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    ABSTRACT: BACKGROUND: We have recently reported from Epilymph, a multicentre case-control study of lymphoma conducted in six European countries, a significant association between NHL and self-reported history of past or present HBV infection based on questionnaire data from face-to-face interviews. METHODS: To corroborate this observation, we used the data and blood specimen from Epilymph to investigate the associations between serological indicators of HBV infection with risk of Hodgkin lymphoma, non-Hodgkin lymphoma (NHL) and specific lymphoma entities. For 1,518 cases and 1,496 controls with sufficient amount of serum or plasma, we tested HBs-antigen, anti-HBc and anti-HBs to distinguish between current or past infection and immunity by vaccination. Statistical analysis was carried out with unconditional logistic regression. RESULTS: We found a positive association of a past HBV infection with multiple myeloma (MM, OR = 1.97, 95 % CL = 1.16-3.37). Non-significant associations were found between past HBV infection and B-cell chronic lymphocytic leukaemia (B-CLL, OR = 1.33, 95 % CL = 0.82-2.16) and T-cell NHL (OR = 1.59, 95 % CL = 0.65-3.90), as well as between current HBV infection and NHL (OR = 1.49, 95 % CL = 0.65-3.41), B-NHL (OR = 1.58, 95 % CL = 0.69-3.64) and diffuse large B-cell lymphoma (DLBCL, OR = 1.50, 95 % CL = 0.47-4.82). Subjects having self-reported HBV infection were serological positive in 75 % of cases and 80 % of controls. For vaccination, the corresponding figures were 49 and 54 %, respectively. CONCLUSION: The present results support previous reports of an association between a history of HBV infection with an elevated lymphoma risk and add multiple myeloma to the list of potentially virus-associated lymphoma entities.
    Journal of Cancer Research and Clinical Oncology 07/2012; · 2.91 Impact Factor

Publication Stats

3k Citations
683.97 Total Impact Points


  • 1991–2014
    • German Cancer Research Center
      • • Division of Cancer Epidemiology
      • • Division of Clinical Epidemiology and Aging Research
      • • Division of Biostatistics
      Heidelburg, Baden-Württemberg, Germany
  • 2013
    • Hospital Italiano de Buenos Aires
      Buenos Aires, Buenos Aires F.D., Argentina
    • IMIM Hospital del Mar Medical Research Institute
      Barcino, Catalonia, Spain
  • 2012
    • National Center for Tumor Diseases (NCT) Heidelberg
      Heidelburg, Baden-Württemberg, Germany
    • Universitätsklinikum Freiburg
      • Center for Chronic Immunodeficiency (CCI)
      Freiburg, Lower Saxony, Germany
  • 2008–2012
    • Università degli studi di Cagliari
      • Department of Public Health, Clinical and Molecular Medicine
      Cagliari, Sardinia, Italy
    • Imperial College London
      • Department of Epidemiology and Biostatistics
      London, ENG, United Kingdom
  • 2008–2010
    • Catalan Institute of Oncology
      • Infections and Cancer Unit
      Badalona, Catalonia, Spain
  • 2007–2010
    • Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
      Dortmund, North Rhine-Westphalia, Germany
  • 1999–2008
    • German Institute of Human Nutrition
      • Department of Epidemiology
      Potsdam, Brandenburg, Germany
  • 2006
    • Institut Català d'Oncologia
      Barcino, Catalonia, Spain
    • National Institutes of Health
      • Division of Cancer Epidemiology and Genetics
      Bethesda, MD, United States
    • International Agency for Research on Cancer
      Lyons, Rhône-Alpes, France
  • 2002
    • Johns Hopkins Bloomberg School of Public Health
      Baltimore, Maryland, United States
    • Lancaster University
      • Department of Mathematics and Statistics
      Lancaster, ENG, United Kingdom