Benavente Yolanda, Casabonne Delphine, Costas Laura, Robles Claudia, Alonso Esther, de la Banda Esmeralda, Gonzalez-Barca Eva, Marcos-Gragera Rafael, Llorca Javier, Tardón Adonina, Monleon José J, Aymerich Marta, Campo Elías, Gimeno-Vázquez Eva, Castaño-Vinyals Gemma, Aragonés Nuria, Pollán Marina, Kogevinas Manolis, de Sanjosé Sílvia
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
Cancer Epidemiol. 2018 Feb;52:106-111. doi: 10.1016/j.canep.2017.12.012. Epub 2018 Jan 4.
Chronic Lymphocytic Leukemia (CLL/SLL) is the most common adult leukemia in Western countries. Although it is mostly an indolent disease it is still incurable and with limited knowledge in relation to its etiology. We aim to confirm and quantify established risk factors for CLL/SLL using a multi-center epidemiological population-based case-control study on CLL/SLL as well as to explore new exposures inconclusively associated with CLL/SLL METHODS: Using the framework provided by the large MCC-Spain case-control study, we explored established and suggested risk factors associated with CLL/SLL using data collected through a face-to-face interview. We estimated odds ratios (OR) and confidence intervals (CI) adjusted by basic confounders, in 1,845 controls from the general population and 560 CLL/SLL from 5 different Spanish regions.
Among the established risk factors, CLL/SLL cases were 3 times more likely to report first degree relatives with an hematological cancer (OR = 3.11, 95% CI 2.10 to 4.61) and nearly twice likely to have ever worked in agriculture (OR = 1.70, 95% CI = 1.34 to 2.16). New findings suggest that women with CLL/SLL were more likely to have central obesity (OR = 1.67 95% CI = 1.12 to 2.48). An inverse association was found for current alcohol consumption (p-trend<0.016) and for type II diabetes.
We confirmed previous established risk factors for CLL/SLL. Among the new findings, further research of central obesity as preventable exposure and the treatment for type II diabetes are warranted.
慢性淋巴细胞白血病（CLL/SLL）是西方国家最常见的成人白血病。尽管它大多是一种惰性疾病，但仍然无法治愈，且对其病因的了解有限。我们旨在通过一项基于人群的多中心CLL/SLL病例对照流行病学研究来确认和量化CLL/SLL的既定风险因素，并探索与CLL/SLL存在不确定关联的新暴露因素。方法：利用大型西班牙MCC病例对照研究提供的框架，我们通过面对面访谈收集的数据，探索与CLL/SLL相关的既定和建议的风险因素。我们估计了由基本混杂因素调整后的优势比（OR）和置信区间（CI），研究对象包括来自普通人群的1845名对照者以及来自西班牙5个不同地区的560例CLL/SLL患者。
在既定风险因素中，CLL/SLL病例报告有血液系统癌症一级亲属的可能性高出3倍（OR = 3.11，95%CI为2.10至4.61），曾从事农业工作的可能性高出近两倍（OR = 1.70，95%CI = 1.34至2.16）。新发现表明，患有CLL/SLL的女性更有可能出现中心性肥胖（OR = 1.67，95%CI = 1.12至2.48）。发现当前饮酒量（p趋势<0.016）和II型糖尿病与之呈负相关。
我们证实了CLL/SLL先前已确定的风险因素。在新发现中，有必要对中心性肥胖作为可预防暴露因素以及II型糖尿病的治疗进行进一步研究。
