malignant year for men and women are greater

malignant effect on both B and T lymphocytes as well as natural killer (NK) lymphocytes, in rare cases. Lymphomas involving the B-cells have the ability to arise from any maturation point in the cell’s development. The median age of onset is approximately 60 years and is believed to continue to increase in the future. In review of all combined subtypes, survival rates at one year for men and women are greater than 70% while the five-year survival rate is above 60% (American Cancer Society, 2017). As NHL diagnoses increase globally, the importance for more research is necessary.Risk Factors Non-Hodgkin lymphoma comprises a group of closely related yet heterogeneous diseases, each characterized by the malignant transformation of lymphoid cells but with distinctive morphologic, immunophenotypic, genetic, and clinical features (Zelenitz, 2010).  B and T lymphocytes, the most commonly affected white blood cells, are involved in cellular and humoral immunity in our bodies. Cellular immunity, also known as cell-mediated immunity, is an immune response that does not involve antibodies, but instead involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes and the release of various cytokines in response to an antigen  (King and Myatt, 2014). Humoral immunity is provided by the antibodies present in the body. Lymphocytes are found in the lymphatic system which is made up of lymph, lymph vessels and lymph nodes. A focus of current research in NHL is establishing modifiable factors that prove to increase the risk of being diagnosed with NHL. However, the majority of the research work has been on comparison of different treatment modalities and protocols to alter or create the most effective disease treatment with the least amount of damage to the host.  Modifiable risk factors are an aspect of the trending research in NHL that nurses have the ability to affect through education.  Many people are attuned to the common risk factors of cancer such as smoking, which is responsible for 28 percent of all cancer deaths (Ng et al., 2014). However, when reading literature on the NHL’s risk factors, some are not as mainstream, but can be modified through awareness and education. One of these risk factors pertains to one’s diet.  Yang et al. (2015) found that there is a positive correlation between both red meat and processed meat and NHL. High intake of red meat and processed meat versus low intake was found to increase risk of NHL by 32 percent and 17 percent, respectively. Mozaheb et al. (2012) had confirming findings to that of Yang et al., however, they studied specific types of red meat as well as how each differed in correlation with NHL. These studies concluded that the meat with the highest risk for development of NHL, was ground beef. Ground beef is of higher risk, because the meat is processed and grilled at high temperatures, generating carcinogens and mutagens (such as heterocyclic amines); “it has been shown that these compounds can induce immunotoxicity and lymphoma” (Mozaheb et al., 2012).  Another component found in processed meat that makes it a danger is nitrite, which is used to fight Clostridium botulinum as an antibacterial agent.  Nitrite is also used to create the familiar pinkish color of cured meats.  When nitrites and nitrates react “with secondary amines and N-alkylamides, a process that can occur endogenously… they can become human carcinogens” (Abid et al., 2014).Although many research projects have established similar findings on correlations between high intake of red meat and NHL, there needs to be more specific and consistent parameters in quantifying red meat consumption.  For example some studies measured intake in grams per day, while others measured consumption in portions per month.  There was also inconsistency in what high intake constituted as studies differed in their methodology.  For instance, Mozaheb et al. (2012) used a questionnaire that consisted of a 9-point system for how often a subject consumed that specific food.  They established the highest score to be “consuming meat once per week.”  This appears to be very different than Abid et al. who found that Americans consume 3.7 pounds per week. Although difficult to establish, studies should attempt to follow one universal system of intake values to find reliability among studies.   Another concern with research of this nature is basing findings on subjective data.  With this kind of research, findings can be skewed by dishonesty, memory, and even mood of subject during interview.  Lastly, Mozaheb et al. had a fairly small sample size (170 patients, 190 controls) which might make one question the results however, Yang et al. (2015) compiled a dataset of 15,189 subjects diagnosed with NHL. This is a substantial sample that helps validate the results of the aforementioned study.  Lastly, there is the possibility of the publication bias in