Abstract 5043: Pre-diagnostic blood levels of organochlorines and risk of non-Hodgkin lymphoma in three population-based cohorts in China and Singapore
Authors: Bassig Bryan A. , Shu Xiao-Ou , Sjodin Andreas , Koh Woon-Puay , Gao Yu-Tang , Adams-Haduch Jennifer , Davis Mark , Wang Renwei , Xiang Yong-Bing , Purdue Mark , Ji Bu-Tian , Yang Gong , Jones Richard , Hosgood H. Dean , Seow Wei Jie , Hu Wei , Zheng Wei , Yuan Jian-Min , Lan Qing , Rothman Nathaniel 
Published: August 2019

Abstract
Background: Organochlorines (OCs) are environmentally persistent compounds that have been extensively used as pesticides and for other industrial applications. Residues of OCs have been detected at hazardous waste sites and in various environmental media worldwide and serum levels of OCs continue to be detectable in the general population. Specific OCs have been associated with non-Hodgkin lymphoma (NHL) risk with varying degrees of evidence. These associations have not been evaluated in Asia, where the exposure patterns of substantially high levels of certain OC pesticides and lower levels of polychlorinated biphenyls (PCBs) are different from Western populations. China accounted for nearly 20% of the worldwide production of dichlorodiphenyltrichloroethane (DDT) through 1983 when it was restricted, and historical usage of hexachlorocyclohexane (HCH) in China has been among the highest in the world.
Methods: We evaluated the risk of NHL in relation to pre-diagnostic blood levels of five OC pesticides/metabolites (hexachlorobenzene, β-HCH, oxychlordane, trans-nonachlor, and p,p’-DDE, the primary metabolite of DDT) and four PCB congeners (118, 138-158, 153, 180) in a case-control study of 167 NHL cases and 167 controls matched on age, sex, and blood collection date. The study was nested within three population-based cohorts of Chinese men and women in Shanghai and Singapore. Associations between lipid-adjusted OC concentrations and NHL risk were analyzed using conditional logistic regression.
Results: Median levels of p,p’-DDE and β-HCH were up to 12 and 65 times higher, respectively, in Shanghai (blood collected between 1986-2000) compared to reported levels in population-based cohorts in the United States (CLUE; Nurse’s Health Study) and Norway (Janus) with blood collected between 1972-1990. Median levels of p,p’-DDE and β-HCH were more comparable in Singapore (blood collected between 2000-2004) relative to the Western cohorts (1-2 fold concentration differences). Levels of β-HCH were associated with increased risk of overall NHL (3rd vs. 1st tertile OR=1.78, 95%CI=0.98-3.23; ptrend =0.049) in the pooled analysis of three cohorts. No significant associations were observed for other OCs and NHL risk, including for p,p’-DDE. Results for β-HCH and p,p’-DDE were consistent across cohorts.
Discussion: Associations between β-HCH and NHL risk have not been consistent in studies of Western populations. Our findings provide the first evidence suggesting associations between blood levels of β-HCH and NHL risk in a population in Asia that experienced far higher exposures. Although there is limited evidence that DDT (IARC Group 2A) is associated with NHL based on studies in Western populations, our findings among Asians, who had higher p,p’-DDE levels than reported in the general population in the West, do not support an association with environmental exposure.
Citation Format: Bryan A. Bassig, Xiao-Ou Shu, Andreas Sjodin, Woon-Puay Koh, Yu-Tang Gao, Jennifer Adams-Haduch, Mark Davis, Renwei Wang, Yong-Bing Xiang, Mark Purdue, Bu-Tian Ji, Gong Yang, Richard Jones, H. Dean Hosgood, Wei Jie Seow, Wei Hu, Wei Zheng, Jian-Min Yuan, Qing Lan, Nathaniel Rothman. Pre-diagnostic blood levels of organochlorines and risk of non-Hodgkin lymphoma in three population-based cohorts in China and Singapore [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5043.