Sun exposure and non-Hodgkin lymphoma: A population-based, case–control study

To investigate the association between sun exposure and risk of non-Hodgkin lymphoma (NHL) by histologic subtypes and to explore whether or not vitamin D intake modify sun–NHL association, we analysed data from a population-based, case–control study conducted in Nebraska between 1999 and 2002. Information on sun exposure during the spring, summer, fall and winter was collected from 387 cases and 535 controls by telephone interview. We found no association between seasonal sun exposure and risk of NHL. Vitamin D intake was also not associated with NHL risk, nor does it modify the sun–NHL association. In contrast, total hours of sun exposure was inversely associated with the risk of NHL (odds ratio (OR) = 0.7 comparing >30 h/week to <14 h/week, 95% confidence interval (CI) = 0.5–1.1). Sun exposure was associated with a lower risk of NHL among farmers (OR = 0.8, 0.5–1.3 for 14–30 h/week; OR = 0.6, 0.3–0.9 for >30 h/week; p-trend = 0.02), but not among non-farmers. Total hours of sun exposure was also inversely associated with risk of diffuse large B-cell lymphoma and T-cell lymphoma. In conclusion, our data suggest that total hours of sun exposure is associated with a lower risk of NHL, and the inverse association is not modified by vitamin D intake, is stronger among farmer, and may vary by subtypes.