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Epidemiology

  • Sally L. GlaserEmail author
  • Ellen T. Chang
  • Christina A. Clarke
  • Theresa H. Keegan
Chapter
Part of the Hematologic Malignancies book series (HEMATOLOGIC)

Abstract

Hodgkin lymphoma (HL) is a relatively rare malignancy with a complex epidemiology. In addition to clinical and histological complexity, it shows substantial variation in incidence and risk factors across demographic factors and tumor characteristics. This chapter provides an overview of the epidemiology of HL with particular attention to this etiologic heterogeneity in incidence patterns, timing of exposure to common infections, the role of Epstein-Barr virus (EBV), altered immune function, genetic susceptibility, and selected lifestyle practices. Altogether, evidence to date points to HL as an uncommon outcome in genetically susceptible individuals of immune dysfunction provoked by early (i.e., childhood) and subsequent environmental exposures. However, given the variations in incidence rates and risk associations with age and tumor EBV status, among other factors, HL has been proposed to comprise four etiologically distinct entities—EBV-associated childhood HL, EBV-associated young-adult HL, EBV-associated HL in older adults (and in the immunosuppressed), and non-EBV-associated HL (occurring primarily in young adults). With this complexity, and the fact that associations with potential etiologic factors have not been strong and/or have low population prevalence, our understanding of risk factors for HL needs to advance considerably to meet the ultimate goal of disease prevention. Furthermore, to account for the considerable epidemiologic heterogeneity of HL, informative future work must be undertaken in diverse study populations of substantial size.

Keywords

Human Leukocyte Antigen Hodgkin Lymphoma Human Leukocyte Antigen Class Infectious Mononucleosis Classical Hodgkin Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

aHR

Adjusted hazard ratio

CI

Confidence interval

COX

Cyclooxygenase

EBNA

Epstein-Barr nuclear antigen

EBV

Epstein-Barr virus

GWAS

Genome-wide association study

HL

Hodgkin lymphoma

HLA

Human leukocyte antigen

HRS

Hodgkin Reed-Sternberg

IL

Interleukin

IM

Infectious mononucleosis

OR

Odds ratio

RR

Relative risk

SEER

Surveillance, Epidemiology, and End Results

SES

Socioeconomic status

SIR

Standardized incidence ratio

SLE

Systemic lupus erythematosus

UK

United Kingdom

USA

United States of America

UVR

Ultraviolet radiation

VCA

Viral capsid antigen

Notes

Acknowledgements

The authors thank Juan Yang for help with this chapter. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s), and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.

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© Springer International Publishing 2015

Authors and Affiliations

  • Sally L. Glaser
    • 1
    • 2
    Email author
  • Ellen T. Chang
    • 3
    • 2
  • Christina A. Clarke
    • 1
    • 2
  • Theresa H. Keegan
    • 1
    • 2
  1. 1.Department of ResearchCancer Prevention Institute of CaliforniaFremontUSA
  2. 2.Department of Health Research and PolicyStanford University School of MedicineStanfordUSA
  3. 3.Health Sciences PracticeExponent, Inc.Menlo ParkUSA

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