Reproductive Factors, Exogenous Hormone Use, and Risk of B-Cell Non-Hodgkin Lymphoma in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition

Research output: Contribution to journalArticle


The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.


  • Laura Costas
  • Leila Lujan-Barroso
  • Yolanda Benavente
  • Naomi E. Allen
  • Pilar Amiano
  • Eva Ardanaz
  • Caroline Besson
  • Heiner Boeing
  • Bas Bueno-de-Mesquita
  • Iris Cervenka
  • Renée T. Fortner
  • Agnès Fournier
  • Marc Gunter
  • Sophia Harlid
  • José María Huerta
  • Rudolf Kaaks
  • Anna Karakatsani
  • Kay Tee Khaw
  • Anastasia Kotanidou
  • Eiliv Lund
  • Giovanna Masala
  • Amalia Mattiello
  • Beatrice Melin
  • Virginia Menéndez
  • Neil Murphy
  • Alexandra Nieters
  • Kim Overvad
  • Elio Riboli
  • Carlotta Sacerdote
  • Maria Jose Sánchez
  • Julie A. Schmidt
  • Sabina Sieri
  • Anne Tjønneland
  • Antonia Trichopoulou
  • Rosario Tumino
  • Roel Vermeulen
  • Elisabete Weiderpass
  • Silvia de Sanjosé
  • Antonio Agudo
  • Delphine Casabonne
External organisations
  • Catalan Institute of Oncology
  • University of Barcelona
  • University of Oxford
  • Biodonostia Health Research Institute
  • Health Research Institute of Navarra (IDISNA)
  • Centre Hospitalier de Versailles
  • Versailles Saint-Quentin-en-Yvelines University
  • Institut Gustave Roussy
  • German Institute of Human Nutrition
  • National Institute for Public Health and the Environment (RIVM)
  • University Medical Center Utrecht
  • Imperial College London
  • University of Malaya
  • German Cancer Research Centre
  • International Agency for Research on Cancer, World Health Organization
  • Umeå University
  • Murcia Regional Health Council
  • Hellenic Health Foundation, Athens
  • National and Kapodistrian University of Athens
  • University of Cambridge
  • UiT The Arctic University of Norway, Tromsø
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • University of Naples Federico II
  • Public Health Directorate
  • Aarhus University
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • University of Granada
  • Istituto Nazionale dei Tumori
  • Danish Cancer Society Research Center
  • Civic and M.P Arezzo Hospital
  • Utrecht University
  • Cancer Registry of Norway Institute of Population-Based Cancer Research
  • Karolinska Institutet
  • Folkhälsan Research Center
  • University of Helsinki
  • PATH (global health organization)
  • L'Hospitalet de Llobregat, Barcelona
  • University of Paris-Sud
  • Attikon University Hospital
  • Evangelismos Athens General Hospital
  • University Medical Center Freiburg
  • Hospital Clínico Universitario San Cecilio
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Public Health, Global Health, Social Medicine and Epidemiology
Original languageEnglish
Pages (from-to)274-281
Number of pages8
JournalAmerican Journal of Epidemiology
Issue number2
Publication statusPublished - 2019
Publication categoryResearch