| Is the Decline of the Increasing Incidence of Non-Hodgkin Lymphoma in Sweden and Other Countries a Result of Cancer Preventive Measures? Lennart Hardell1,2 and Mikael Eriksson3
1Department of Oncology, University Hospital, and 2Department of Natural Sciences, Örebro University, Örebro, Sweden; 3Department of Oncology, University Hospital, Lund, Sweden Abstract
Is the decline of the increasing incidence of non-Hodgkin lymphoma (NHL) in Sweden and other countries a result of cancer preventive measures? The yearly age-standardized incidence of NHL increased significantly in Sweden during 1971-1990, for men an average of 3.2% and for women 3.1%. The corresponding figures for 1991-2000 were -0.8% and -0.2%, respectively. A decline of the increasing incidence has also been seen in other countries, such as the United States, Finland, and Denmark. Immunosuppression is one established risk factor for NHL, possibly with interaction with Epstein-Barr virus. Phenoxyacetic acids and chlorophenols, both pesticides, have been associated with NHL. Use of these chemicals was banned in Sweden in 1977 and 1978, respectively. Also, persistent organic pollutants such as polychlorinated biphenyls, hexachlorobenzene, chlordanes, and dioxins have been shown to increase the risk. Exposure of the whole population occurs predominantly through the food chain. Exposure to such chemicals was highest in the 1960s and 1970s. Because of regulation in the 1970s, exposure has declined substantially in the population. The change in incidence of NHL in Sweden and other countries may serve as a good example of how prohibition and limitation of exposure may be reflected in cancer statistics some decades later. Key words: incidence, non-Hodgkin lymphoma, persistent organic pollutants, pesticides, prevention. Environ Health Perspect 111:1704-1706 (2003) . doi:10.1289/ehp.6270 available via http://dx.doi.org/ [Online 2 July 2003] Address correspondence to L. Hardell, Department of Oncology, University Hospital, SE-701 85 Örebro, Sweden. Telephone: 46-19-602-10-00 Fax: 46-19-10-17-68. E-mail: lennart.hardell@orebroll.se This work was supported by grants from Cancer-och Allergifonden, Nyckelfonden, Örebro Cancer Fund. The authors declare they have no conflict of interest. Received 10 February 2003 ; accepted 1 July 2003.
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