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Epidemiology

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Hodgkin Lymphoma

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

Abstract

Hodgkin lymphoma (HL) is a relatively rare malignancy, occurring in the United States (US) at approximately 1/20th the rate of lung cancer, and 1/7th the rate of non-Hodgkin lymphoma in 2006 [1]. Yet, it has inspired a high degree of scientific interest because of the heterogeneity of its clinical presentation and behavior, with some aspects characteristic of malignancy but others recalling an infectious process; the complexity of its histology, including the infrequent malignant Hodgkin Reed–Sternberg (HRS) cell in an otherwise normal reactive infiltrate, and the variability of cell surface markers [2]; and its unusual occurrence in children and young adults, in whom it is one of the most common cancers [1], as well as in older persons. Motivated by these characteristics and MacMahon’s seminal papers on the epidemiology of HL in 1957 and 1966 [3, 4], epidemiologists have worked to disentangle the complexity of this disease so as to arrive at a clear understanding of its pathogenesis and etiology. However, even as findings from this research have helped elucidate some aspects of HL etiology, they have continued to reveal significant epidemiologic heterogeneity across patient groups that recalls the disease’s clinical and pathologic complexity. This heterogeneity complicates the interpretation of epidemiologic research conducted for HL as a single entity and perhaps challenges the classification of what is currently categorized as HL. Indeed, in 1999, HL was split into two main groups – classical HL, which comprises the majority of the subtypes, and lymphocyte-predominant HL, an uncommon disease considered a B-cell lymphoma despite HRS cell presence [5]. Regardless, the central feature of classical HL epidemiology is the very consistent observation of heterogeneity in its occurrence and risk factors.

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Abbreviations

CI:

Confidence interval

COX:

Cyclooxygenase

EA:

Early antigen

EBNA:

Epstein–Barr nuclear antigen

EBV:

Epstein–Barr virus

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

US:

United States

UVR:

Ultraviolet radiation

VCA:

Viral capsid antigen

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Acknowledgments

The authors thank Kari Fish, Sarah Shema, and June Kristine Winters for help with this chapter. The collection of cancer incidence data used in this chapter was supported by the California Department of Health Services 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 N01-PC-35136 awarded to the Northern California Cancer Center (now the Cancer Prevention Institute of California), contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California, Department of Health Services, 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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  1. Cancer Prevention Institute of California (formerly the Northern California Cancer Center), 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA

    Sally L. Glaser, Ellen T. Chang, Christina A. Clarke & Theresa H. Keegan

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Correspondence to Sally L. Glaser .

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  1. Klinik I für Innere Medizin, Universität Köln, Joseph-Stelzmann-Str. 9, Köln, 50924, Germany

    Andreas Engert

  2. Dept. Medicine, Stanford University, Stanford, 94305-5479, California, USA

    Sandra J. Horning

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Glaser, S.L., Chang, E.T., Clarke, C.A., Keegan, T.H. (2011). Epidemiology. In: Engert, A., Horning, S. (eds) Hodgkin Lymphoma. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-12780-9_1

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