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Temporal patterns of association between cigarette smoking and leukemia risk

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Abstract

Objectives

To evaluate variation in smoking-related leukemia risk with time-since-exposure.

Methods

We analyzed data from a population-based case–control study conducted in Germany. Odds ratios were estimated by applying conditional logistic regression methods to 470 incident leukemia cases and 1,009 controls. Cases were classified as acute non-lymphocytic leukemia (ANLL), acute lymphocytic leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). Temporal variation in the impact of smoking on leukemia risk was assessed via exposure time-windows and a spline latency function.

Results

Current smokers were at greater risk of ANLL than those who never smoked (OR = 1.65 95% CI: 0.95, 2.87) and a positive trend was observed in ANLL risk with cumulative pack-decades smoked, under a 2-year exposure lag assumption (OR/pack-decade = 1.11 95% CI: 0.96, 1.30). This was primarily due to the association between ANLL and smoking in the period 2 to <10 years prior (OR/pack-decade = 2.72 95% CI: 0.93, 7.99). There was minimal evidence of association between ANLL risk and packs smoked 10 or more years prior. CML and ALL exhibited minimal evidence of association with smoking status. CLL exhibited a positive association with smoking in the periods 2 to <10 years and 10 to <20 years prior to diagnosis although estimates of association were highly imprecise.

Conclusions

The temporal pattern of smoking-induced ANLL risk appears to follow a prompt peak in excess incidence that diminishes with time since exposure.

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Acknowledgments

David Richardson was supported by the Alfried-Krupp-von Bohlen und Halbach Foundation Fellowship Program “Life Sciences – Medizin, Lebens- und Gesundheitswissenschaften” at the Alfried-Krupp-Kolleg, Greifswald, Germany.

Author information

Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

    David B. Richardson

  2. Institute for Community Medicine, Section Health Care Epidemiology and Community Health, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany

    Claudia Terschüren & Wolfgang Hoffmann

  3. Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Bremen, Germany

    Hermann Pohlabeln

  4. Institute for Medical Informatics, Biometry, and Epidemiology (IMIBE), Medical Faculty, University of Duisburg-Essen and University Clinics of Essen, Essen, Germany

    Karl-Heinz Jöckel

Authors
  1. David B. Richardson
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  2. Claudia Terschüren
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  3. Hermann Pohlabeln
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  4. Karl-Heinz Jöckel
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  5. Wolfgang Hoffmann
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Corresponding author

Correspondence to David B. Richardson.

Additional information

Institute in which the work was performed: Institute for Community Medicine, Section Health Care Epidemiology and Community Health, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.

Appendix

Appendix

Table A1 Estimated odds ratios (and associated 95% confidence intervals) for subtypes of adult leukemia (ages 15–75 years) by socioeconomic status
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Richardson, D.B., Terschüren, C., Pohlabeln, H. et al. Temporal patterns of association between cigarette smoking and leukemia risk. Cancer Causes Control 19, 43–50 (2008). https://doi.org/10.1007/s10552-007-9068-7

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  • DOI: https://doi.org/10.1007/s10552-007-9068-7

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