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Table 1 Characteristics of included studies according to report type

From: The relationship between physical activity and lymphoma: a systematic review and meta analysis

Authors, year, gender Study Region Case number Controls or cohort values Median age, years (SD) Lymphoma subtype Physical activity domain, timing, definition of high vs. low PA RR/OR/HR (95% CI), high vs. low PA Adjustment Factors
Cohort Studies
 Barberio et al., 2018 [17] Men and women combined Canada (North America) 91 (NHL) 285,787 person-years follow up M: 57.8 (8.2) W: 55.9 (9.0) *all cancer cases NHL Total, recent (201.2–535.3 vs. 0–113.7 MET hours/wk) HR 0.73 (0.40–1.36) Age, sex, ethnicity (white/other), marital status, education level, total household income, geographic area of residence (urban/rural), smoking status, mean alcohol intake (g/d), mean energy intake (kCal/day), self-reported BMI, history of cardiovascular or respiratory condition, family history of cancer (breast or endometrial if female), other PA
Recreational, recent (35–255.3 vs. 0–7.4 MET hours/wk) HR 0.86 (0.45–1.65)
Occupational, recent (116.8–463.4 vs. 0–34.6 MET hours/wk) HR 0.68 (0.35–1.31)
 Cerhan et al., 2002 [22] Women USA (North America) 261 (NHL) 137 (DLBCL) 58 (FL) 37,932 cohort 449,801 person years of follow up 61.7 (no SD reported) NHL DLBCL FL Recreational, recent (High vs. low) NHL: RR 0.84 (0.62–1.15) Age
DLBCL: RR 1.0 (0.66–1.52)
FL: RR 0.58 (0.29–0.18)
 Kabat et al., 2012 [23] Women USA (North America) 1123 (NHL) 302 (DLBCL) 214 (FL) 298 (CLL/SLL) 157,852 cohort Cases: 65.2 (6.9) Non-cases 63.2 (7.2) NHL DLBCL FL CLL/SLL Recreational, recent (≥17.5 vs. < 1.6 MET hours/wk) NHL: HR 1.17 (0.98–1.39) Age (continuous), alcohol intake, smoking (pack-years), caloric intake, education level, race/ethnicity, BMI, enrollment in OS/treatment arm assignment
DLBCL: HR 1.03 (0.73–1.45)
FL: HR 1.22 (0.83–1.80)
CLL/SLL: HR
1.18 (0.84–1.66)
 Lim et al., 2007 [24] Men and women combined USA (North America) 1381 (NHL) 58 (HL) 472,545 non-cases 60.9–62.5 depending on covariate classification NHL DLBCL FL CLL/SLL T cell HL Recreational, recent (NHL ≥5 vs. < 1x/wk.; HL 3- ≥ 5 vs. < 1/wk. activities ≥20 min with increased heart rate and sweating) NHL: RR 0.97 (0.81–1.16) Age, race, education, BMI, caloric intake
DLBCL: RR 0.87 (0.61–1.25)
FL: RR 0.96 (0.63–1.46)
CLL/SLL: RR 0.80 (0.51–1.25)
T-cell: RR 1.25 (0.62–2.49)
HL: RR 1.60 (0.72–3.54)
 Lu et al., 2009 [25] Women USA (North America) 574 (NHL) 155 (DLBCL) 121 (FL) 124 (CLL/SLL) 120,642 cohort Cohort entry: 52.7 Diagnosis: 69.5 NHL DLBCL FL CLL/SLL Recreational, lifetime NHL: RR 1.00 (0.78–1.29) Height, weight at cohort entry, age at menarche; recent PA also adjusted for long-term strenuous and moderate exercise
DLBCL: RR 0.97 (0.60–1.55)
FL: RR 1.29 (0.69–2.41)
CLL/SLL: RR 0.94 (0.55–1.60)
Recreational, Recent (≥4 vs. 0–0.5 h/wk./year of strenuous activity) NHL: RR 1.11 (0.86–1.44)
DLBCL: RR 1.00 (0.62–1.62)
FL: RR 1.01 (0.57–1.79)
CLL/SLL: RR 1.50 (0.86–2.63)
 Pukkala et al., 2000 [26] Men Finland (Europe) 6 (NHL) 3 (HL) 53,501 person years follow up Modal age category 45–59 years NHL HL Recreational, lifetime (Athletes vs. Finnish population) NHL: SIR 0.78 (0.29–1.70) None
HL: SIR 1.33 (0.27–3.88)
 Teras et al., 2012 [27] Men Women USA (North America) 2002 (NHL) 435 (DLBCL) 280 (FL) 482 (CLL/SLL) 326 (B-NHL) 110 (T-NHL) 26 (NHL NOS) 184,190 cohort 62.9 (6.4) NHL DLBCL FL, CLL/SLL B-NHL T-NHL NHL NOS Recreational, recent (≥17.5 vs. 0 MET hours/wk) NHL- M: HR 1.02 (0.82–1.26) W: HR 0.69 (0.54–0.89) Age at baseline, family history of hematopoietic cancer, education, smoking status, alcohol intake, height, BMI, sitting time
DLBCL- M: HR 1.14 (0.70–1.88) W: HR 0.71 (0.44–1.16)
CLL/SLL-M: HR 0.95 (0.62–1.46) W: HR 0.73 (0.44–1.20)
FL- M: HR 0.86 (0.49–1.51) W: HR 0.77 (0.41–1.43)
 Van Veldhoven et al., 2011 [28] Men Women Men and women combined Europe 778 (NHL) 94 (DLBCL) 98 (FL) 142 (B-CLL) 109 (B-NOS) 521,457 cohort Age at recruitment: 52.9 (9.8) men, 51.0 (10.9) women NHL DLBCL FL B-CLL B-NOS Total, recent (Active vs. inactive) NHL- M: HR 0.83 (0.31–2.24) W: HR 1.50 (0.45–5) Hypertension, hyperlipidemia, education, diabetes; age and centre stratified *No adjustment for subtypes of NHL
DLBCL- M: HR 2.03 (0.38–10.79) W: HR 5.03 (1.19–21.33)
FL- M: HR 2.82 (0.52–15.23) W: HR 2.59 (0.54–12.38)
B-CLL- M: HR 0.76 (0.23–2.53) W: HR 10.95 (1.55–77.48)
B-NOS- M: HR 0.16 (0.01–1.95) W: HR 1.60 (0.20–12.52)
Occupational, recent (Manual/heavy labor vs. sedentary) NHL- M: HR 1.05 (0.46–2.41) W: HR 2.06 (0.65–6.51)
Recreational, recent (≥45.75 vs. < 14.25 MET hours/wk) NHL- M: HR 1.11 (0.49–2.52) W: HR 1.25 (0.49–3.16)
 Walter et al., 2013 [18] Men and women combined USA (North America) 441 (Mature B cell) 104 (CLL) 257 (Other mature B cell) 22 (HL) 65,322 cohort 61.5 (7.4) Mature B cell neoplasms (including plasma cell disorders) CLL Other mature B cell Recreational, lifetime (> 4.8 vs. 0.2–1.8 MET hours/wk) *not reported for mature B cell Age, sex, race/ethnicity, education, smoking, BMI at baseline, fatigue/lack of energy, self reported health, daily fruit consumption, daily vegetable consumption, history of anemia in year before baseline, family history of leukemia or lymphoma
CLL: HR 0.52 (0.26–1.03)
Other mature B cell: HR 0.80 (0.53–1.22)
Case- Control Studies
 Boyle et al., 2015 [15] Men Women Men and women combined Canada (North America) 749 (NHL) 202 (DLBCL) 188 (FL) 268 (Other B cell) 70 (T cell) 818 controls Modal age category 70+ years (cases), 60–69 years (controls) NHL DLBCL FL Other B cell T cell Total non-occupational, lifetime (≥85 vs. 0–35.9 MET hours/wk) NHL- M/W: OR 1.16 (0.87–1.55) M: OR 1.14 (0.78–1.68) W: OR 1.07 (0.68–1.68) Age group, sex, residential location, ethnicity
DLBCL: OR 1.22 (0.79–1.88)
FL: OR 1.26 (0.80–1.99)
Other B cell: OR 1.04 (0.69–1.57)
T cell: OR 1.19 (0.61–2.32)
 Brownson et al., 1991 [29] Men USA (North America) 536 (NHL) 16,611 controls Not reported NHL Occupational, recent (> 80% vs. < 20% active at work) OR 0.83 (0.56–1.25) Age, smoking
 Cerhan et al., 2005 [30] Men and women combined USA (North America) 562 (NHL) 32 (DLBCL) 24 (FL) 468 controls* *Population with PA data (Total cases 1321, controls 1057 in study) Cases: 56.1 years (12.9) Controls: 59.7 years (11.7) NHL DLBCL FL Occupational, lifetime (Mostly exercise vs. mostly sit at work) NHL: OR 0.98 (0.55–1.74) Age, sex, race and study center, BMI, height
DLBCL: OR 1.32 (0.63–2.76)
FL: OR 1.04 (0.45–2.37)
Non-occupational, lifetime (> 1080 vs. 0 MET hours/wk) NHL: OR 0.83 (0.50–1.38)
DLBCL: OR 0.82 (0.41–1.66)
FL: OR 0.85 (0.39–1.83)
 Etter et al., 2018 [16] Men Women USA (North America) 236 (NHL) 87 (HL) Controls 952 (NHL); 348 (HL) NHL: 56.31 (15.42) NHL HL Recreational, lifetime (≥1 vs. < 1 exercise session/wk) NHL: OR 0.74 (0.55–0.99) Age, sex, BMI, family history of lymphoma, smoking (pack-years), education level (HL only)
HL: 32.90 (10.59) HL: OR 0.53 (0.32–0.87)
 Keegan et al., 2006 [31] Women USA (North America) 312 (HL) 325 controls 35 (SD not reported) HL Recreational, lifetime 19–44 years: OR 0.71 (0.48–1.05) Age, race/ethnicity, educational level, Jewish upbringing, smoking status 1 year before diagnosis/interview, nursed children, number of miscarriages, having a first or second degree relative hx of lymphoma, Jewish heritage, single room at age 11, living in a single family home at age 8 years, living in a rented family home at age 8 years
45–79 years: OR 0.35 (0.09–1.36)
Recreational, recent (≥2 vs. < 2 strenuous activities/wk. for > 1 month) 19–44 years: OR 0.58 (0.39–0.87)
45–79 years: OR 0.45 (0.19–1.06)
 Kelly et al., 2012 [32] Men Women Men and women combined USA (North America) 950 (NHL) 181 (DLBCL) 242 (FL) 302 (CLL/SLL) 1146 controls 63 (SD not reported) NHL FL CLL/SLL DLBCL Recreational, recent (> 45 vs. 1.08 MET hours/wk) *also reported recreational, early adulthood (not listed) NHL: M/W- OR 1.03 (0.80–1.33) M- OR 1.37 (0.98–1.92) W- OR 0.71 (0.47–1.07) Age at enrollment, gender and county of residence
DLBCL: M/W- OR 0.99 (0.62–1.59) M- OR 1.19 (0.64–2.21) W- OR 0.80 (0.38–1.69)
FL: M/W- OR 0.98 (0.65–1.48) M- OR 0.96 (0.53–1.72) W- OR 0.90 (0.49–1.67)
CLL: M/W- OR 1.09 (0.75–1.58) M- OR 1.71 (1.08–2.70)
W- OR 0.53 (0.27–1.06)
 Pan et al., 2005 [33]
Men
Women
Men and women combined
Canada (North America) 1030 (NHL)
419 (DLBCL)
242 (FL)
100 (SLL)
269 (NHL NOS)
3106 controls
Men-
Cases: 56.7 (12.5)
Controls: 57.9 (14.6)
NHL
DLBCL
FL
SLL
NHL Not otherwise specified (NOS)
Recreational, recent
(≥34.4 vs. < 6.3 MET hours/wk)
NHL:
M- OR 0.79 (0.59–1.05)
W- OR 0.59 (0.42–0.81)
Age, province of residence, education, alcohol consumption, pack-years of smoking, total calorie intake, self-reported exposure to some chemicals, ever employment in some occupations, BMI, total calorie intake
Women-
Cases: 57.1 (12.6)
56.2 (12.2)
DLBCL: OR 0.84 (0.62–1.13)
FL: OR 0.64 (0.42–0.97)
SLL: OR 0.74 (0.41–1.33)
NHL NOS: OR 0.64 (0.45–0.92)
 Parent et al., 2011 [34]
Men
Canada (North America) 215 (NHL)
54 (HL)
533 controls
Cases: 58.9 (8.01)
Controls: 59.6 (7.91)
NHL
HL
Occupational, recent
(≥75% active vs. ≥75% sedentary at work)
NHL: OR 0.56 (0.26–1.20)
HL: OR 0.84 (0.17–4.23)
Age, ethnicity, educational level, socioeconomic status, respondent status, BMI, smoking, other PA
Recreational, recent
(≥1 vs. <1x/wk. sports or activity)
NHL: OR 1.17 (0.81–1.69)
HL: OR 0.97 (0.45–2.08)
Overall, recent
(Intermediate activity at work + recreational PA or high PA at work vs. other)
NHL: OR 0.85 (0.60–1.21)
HL: OR 1.20 (0.58–2.47)
 Zahm et al., 1999 [35]
Men
Women
USA (North America) 1177 (NHL)
3625 control
Median not reported.
Modal age category 45–84 years (cases), 75+ years (1162 controls)
NHL Occupational, lifetime or “usual” occupation
(M > 12 vs. < 8; W > 8 vs. < 5 k Joules/min)
M: OR 1.0 (0.7–1.3)
W: OR 1.7 (0.2–11.5)
Age, state of residence
  1. **PA Physical activity, M Men, W Women, M/W Men/Women Combined, NHL Non-Hodgkin lymphoma, DLBCL Diffuse large B cell lymphoma, FL Follicular lymphoma, CLL/SLL Chronic lymphocytic leukemia/small lymphocytic lymphoma, NOS Not otherwise specified, HL Hodgkin lymphoma, BMI Body mass index