No Increased Risk of Non-Hodgkin's Lymphoma with Steroids, Estrogens and Psychotropics (Netherlands)

Objective: Earlier studies with data on drug use from interview suggested that corticosteroids, estrogens and psychotropics may increase the risk of non-Hodgkin's lymphoma (NHL). The objective of this case-control study with complete pharmacy records was to investigate whether these results could be reproduced. Methods: Cases were all subjects aged 20 years and older in a population of approximately 300,000 residents in the Netherlands who were registered with an incident primary discharge diagnosis of NHL between January 1, 1991 and December 31, 1998. Controls were matched to cases on sex, year of birth, community pharmacy, calendar period and total duration of medication history. Conditional logistic regression was used to evaluate the association between categories of cumulative drug use in days and the risk of NHL. Results: 997 controls were matched to 251 cases of NHL that occurred during the study period. In multivariate analyses, there was no statistically significant risk increase of NHL after exposure to corticosteroids, estrogens or psychotropics. Moreover, long-term use of benzodiazepines showed an unexpected statistically significant protective effect (OR 0.34; 95% confidence interval 0.18-0.64). Conclusions: In our population-based study, corticosteroids, estrogens and psychotropics were not associated with an increased risk of NHL.