Latitude gradients for lymphoid neoplasm subtypes in Australia support an association with ultraviolet radiation exposure

Authors

  • Marina T. van Leeuwen,

    Corresponding author
    • Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
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  • Jennifer J. Turner,

    1. Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie University, Sydney, Australia
    2. Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
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  • Michael O. Falster,

    1. Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
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  • Nicola S. Meagher,

    1. Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
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  • David J. Joske,

    1. Sir Charles Gairdner Hospital, The University of Western Australia, Perth, Australia
    2. School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
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  • Andrew E. Grulich,

    1. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
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  • Graham G. Giles,

    1. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
    2. Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Parkville, Victoria, Australia
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  • Claire M. Vajdic

    1. Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
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  • The study was conceived and designed by M.T.v.L. and C.M.V. The data were obtained from data custodians by M.T.v.L. and C.M.V. All authors contributed to the analytical plans. The data were analyzed by M.T.v.L. and M.O.F. M.T.v.L. and C.M.V. drafted the manuscript. All authors reviewed, revised and approved the final draft.

Correspondence to: Marina T. van Leeuwen, NHMRC Postdoctoral Research Fellow, Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, The University of New South Wales, Sydney NSW 2052, Australia, Tel.: 612–9385 8638, Fax: 612–9385-1430, E-mail: m.vanleeuwen@unsw.edu.au

Abstract

Given the uncertainty surrounding solar ultraviolet radiation (UVR) exposure and risk of lymphoid neoplasms, we performed an ecological analysis of national Australian data for incident cases diagnosed between 2002 and 2006. Subtype-specific incidence was examined by latitude band (<29°S, 29–36°S, ≥37°S), a proxy for ambient UVR exposure, using multiple Poisson regression, adjusted for sex, age-group and calendar year. Incidence increased with distance from the equator for several mature B-cell non-Hodgkin lymphomas, including diffuse large B-cell [incidence rate ratio (IRR) = 1.37; 95% confidence interval (CI): 1.16–1.61 for latitude ≥37°S relative to <29°S], lymphoplasmacytic (IRR = 1.34; 95% CI: 1.12–1.61), mucosa-associated lymphoid tissue (IRR = 1.32; 95% CI: 0.97–1.80) and mantle cell lymphoma (IRR = 1.29; 95% CI: 1.05–1.58), as well as plasmacytoma (IRR = 1.52; 95% CI: 1.09–2.11) and plasma cell myeloma (IRR = 1.15; 95% CI: 1.03–1.27). A similar pattern was observed for several mature cutaneous T-cell neoplasms, including primary cutaneous anaplastic large cell lymphoma (IRR = 4.26; 95% CI: 1.85–9.84), mycosis fungoides/Sézary syndrome (IRR = 1.72; 95% CI: 1.20–2.46), and peripheral T-cell lymphoma not otherwise specified (NOS) (IRR = 1.53; 95% CI: 1.17–2.00). Incidence of mixed cellularity/lymphocyte-depleted (IRR = 1.60; 95% CI: 1.16–2.20) and nodular sclerosis Hodgkin lymphoma (IRR = 1.57; 95% CI: 1.33–1.85) also increased with distance from the equator. Many of these subtypes have a known association with infection or immune dysregulation. Our findings support a possible protective effect of UVR exposure on the risk of several lymphoid neoplasms, possibly through vitamin D-related immune modulation critical in lymphomagenesis.

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