Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition

Silke Hermann, Sabine Rohrmann, Jakob Linseisen, Alexandra Nieters, Aneire Khan, Valentina Gallo, Kim Overvad, Anne Tjønneland, Ole Raaschou-Nielsen, Manuela M. Bergmann, Heiner Boeing, Nikolaus Becker, Rudolf Kaaks, H. Bas Bueno-De-Mesquita, Anne M. May, Roel C H Vermeulen, Sheila Bingham, Kay Tee Khaw, Timothy J. Key, Ruth C. TravisAntonia Trichopoulou, Christina Georgila, Dimitra Triantafylou, Egidio Celentano, Vittorio Krogh, Giovanna Masala, Rosario Tumino, Antonio Agudo, Jone M. Altzibar, Eva Ardanaz, Carmen Martínez-García, Marcial Vicente Argüelles Suárez, Maria José Tormo, Tonje Braaten, Eiliv Lund, Jonas Manjer, Sophia Zackrisson, Göran Hallmans, Beatrice Malmer, Paolo Boffetta, Paul Brennan, Nadia Slimani, Paolo Vineis, Elio Riboli

Research output: Contribution to journalArticlepeer-review


Introduction: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study. Materials and methods: Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk. Results: Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02-1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27-0.79) versus lowest educational level. No association was found for HL. Conclusion: We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalJournal of Cancer Research and Clinical Oncology
Issue number1
Publication statusPublished - Jan 2010


  • Cohort study
  • Education
  • Lymphomas
  • SES

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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