Oral contraceptives, menopausal hormone therapy use and risk of B-cell non-Hodgkin lymphoma in the California Teachers Study

Int J Cancer. 2011 Aug 15;129(4):974-82. doi: 10.1002/ijc.25730. Epub 2010 Dec 8.

Abstract

We examined oral contraceptive (OC) and menopausal hormonal therapy (MHT) use in relation to risk of B-cell non-Hodgkin lymphoma (NHL). Women under age 85 years participating in the California Teachers Study with no history of hematopoietic cancer were followed from 1995 through 2007. A total of 516 of 114,131 women eligible for OC use analysis and 402 of 54,758 postmenopausal women eligible for MHT use analysis developed B-cell NHL. Multivariable adjusted and age stratified Cox proportional hazards models were fit to estimate relative risks (RRs) and 95% confidence intervals (95% CI). Ever versus never OC use was marginally associated with lower B-cell NHL risk, particularly among women first using OCs before age 25 years (RR=0.72, 95% CI=0.51-0.99); yet, no duration-response effect was observed. No association was observed for ever versus never MHT use among postmenopausal women (RR=1.05, 95% CI=0.83-1.33) overall or by formulation (estrogen alone, ET, or estrogen plus progestin, EPT). Among women with no MHT use, having bilateral oophorectomy plus hysterectomy was associated with greater B-cell NHL risk than having natural menopause (RR=3.15, 95% CI=1.62-6.13). Bilateral oophorectomy plus hysterectomy was not associated with risk among women who used ET or EPT. These results indicate that exogenous hormone use does not strongly influence B-cell NHL risk.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • California / epidemiology
  • Cohort Studies
  • Contraceptives, Oral / adverse effects*
  • Female
  • Follow-Up Studies
  • Hormone Replacement Therapy / adverse effects*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / chemically induced
  • Leukemia, Lymphocytic, Chronic, B-Cell / epidemiology
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy
  • Lymphoma, B-Cell / chemically induced*
  • Lymphoma, B-Cell / epidemiology
  • Lymphoma, B-Cell / therapy
  • Lymphoma, Follicular / chemically induced
  • Lymphoma, Follicular / epidemiology
  • Lymphoma, Follicular / therapy
  • Lymphoma, Large B-Cell, Diffuse / chemically induced
  • Lymphoma, Large B-Cell, Diffuse / epidemiology
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Menopause / drug effects*
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Contraceptives, Oral