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Hodgkin Lymphoma pp 3–26Cite as

Epidemiology

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Part of the book series: Hematologic Malignancies ((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.

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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

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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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Authors and Affiliations

  1. Department of Research, Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA

    Sally L. Glaser PhD, Christina A. Clarke PhD, MPH & Theresa H. Keegan PhD

  2. Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, 94306, USA

    Sally L. Glaser PhD, Ellen T. Chang Sc.D., Christina A. Clarke PhD, MPH & Theresa H. Keegan PhD

  3. Health Sciences Practice, Exponent, Inc., 149 Commonwealth Drive, Menlo Park, CA, 94025, USA

    Ellen T. Chang Sc.D.

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  1. Sally L. Glaser PhD
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  2. Ellen T. Chang Sc.D.
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  3. Christina A. Clarke PhD, MPH
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  4. Theresa H. Keegan PhD
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Corresponding author

Correspondence to Sally L. Glaser PhD .

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Editors and Affiliations

  1. Universitätsklinikum Köln Klinik I für Innere Medizin, Köln, Germany

    Andreas Engert

  2. Memorial Sloan - Kettering Cancer Center, New York, New York, USA

    Anas Younes

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Glaser, S.L., Chang, E.T., Clarke, C.A., Keegan, T.H. (2015). Epidemiology. In: Engert, A., Younes, A. (eds) Hodgkin Lymphoma. Hematologic Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-319-12505-3_1

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  • DOI: https://doi.org/10.1007/978-3-319-12505-3_1

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