A Hospital-Based Case-Control Study of Non-Hodgkin Lymphoid Neoplasms in Shanghai: Analysis of Personal Characteristics, Lifestyle, and Environmental Risk Factors by Subtypes of the WHO Classification

Objectives: To investigate potential risk factors (personal characteristics, lifestyle, and environmental factors) of non-Hodgkin lymphoid neoplasms (NHLN), including lymphomas and lymphocytic leukemia, according to the World Health Organization classification. Materials and Methods: The investigation was a hospital-based case-control Study consisting of 649 confirmed NHLN cases and 1298 individually gender-age-matched patient controls at 25 hospitals in Shanghai. A 17-page questionnaire was used to obtain information on demographics, medical history, family history, lifestyle risk factors, employment history, residential history, and occupational and non-occupational exposures. Risk estimates were calculated using conditional logistic regression models. Results: Potential risk factors of NHLN (all subtypes combined) or individual subtypes included low-level education, home or workplace renovation, living on a farm, planting crops, and raising livestock or animals. Some risk factors applied to all or most subtypes (such as lowlevel education, living on a farm, and raising livestock or animals), whereas others did not (such as the use of traditional Chinese medicines, which was associated with a reduced risk). Blood transfusions, hair dyes, or living near high-voltage power lines were not associated with an increased risk. Conclusions: The study identified a number of risk factors for NHLN overall and specific subtypes. Some risk factors were subtype-specific. The difference in risk by subtype underscores the etiologic commonality and heterogeneity of NHLN subtypes.