Infectious Mononucleosis and Hodgkin's Disease—a Similar Seasonality

As, Douglas; Brown, Thelma; Reid, Daniel

doi:10.3109/10428199609054835

Cited by 28 publications

(17 citation statements)

References 16 publications

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“…4,9 However, the incidence trough among young women, as well as young adults overall, in August supports other reports of a summer deficit. 6,9 Our observation of a slight February incidence peak among adults over age 50 conflicts with reports in other populations that found no seasonal variation in older adults, [3][4][5] although no peak was observed in older men or older women alone in our study. The lack of variation in incidence patterns by era of diagnosis (1958 to 1978 vs. 1979 to 1998) suggests that improvements in diagnostic methods over recent decades 19 did not affect seasonal patterns in HL diagnosis.…”

Section: Discussioncontrasting

confidence: 99%

“…Acute infectious mononucleosis, a frequent outcome of EBV infection and a known risk factor for HL, 10 shares a similar seasonal presentation with HL, both peaking around March. 5 One study estimated the median time between infectious mononucleosis and the onset of EBV genome-positive HL at 4.1 years, with a peak at 2.4 years. 20 However, other environmental and endogenous exposures that vary seasonally, such as sunlight exposure, melatonin levels and reproductive and immune system function, 21 may contribute to seasonal incidence.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] In particular, the Epstein-Barr virus (EBV) appears to play an etiologic role in at least a portion of HL cases. 10 Several previous studies, 3,4,6,9 but not all, 8 have found a peak in HL diagnoses occurring in or near the month of March, especially among younger patients.…”

mentioning

confidence: 99%

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Seasonal variation in the diagnosis of Hodgkin lymphoma in Sweden

Chang

Blomqvist

Lambe

2005

Intl Journal of Cancer

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Epidemiologic evidence suggests a seasonal pattern in the occurrence of Hodgkin lymphoma (HL), with an incidence peak around the month of March. This pattern may reflect seasonal variation in the prevalence of an infectious agent involved in HL development. Using Poisson regression, we examined monthly variation in HL diagnosis in Sweden between 1958 and 1998, based on data from the population‐based Swedish Cancer Registry. Older adults (50 to 79 years) were marginally more likely to be diagnosed in February, but there was no monthly variation after stratifying by sex. Young adult males (15 to 49 years) presented more often in February, whereas young adult females presented less often in August and December. Among children (<15 years), boys were significantly more likely to have been diagnosed in March, whereas there was no seasonal incidence pattern among girls. The seasonal pattern in HL diagnosis among young adults and boys is consistent with an infectious origin, whereas the results among older adults neither support nor dispute the possibility of an infectious etiology in this age group. © 2005 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Seasonal variation in the diagnosis of Hodgkin lymphoma in Sweden

Chang

Blomqvist

Lambe

2005

Intl Journal of Cancer

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“…76 These cancers, as well as testicular cancer and multiple myeloma, have the square of latitude correlated with mortality rate for 1950-1969, and some do for 1970-1994. Because latitude is an index of wintertime vitamin D production from solar UVB irradiance, and winter is the period of many viral infections such as EBV 112 and influenza, 113 this hypothesis is reasonable. Evaluating this hypothesis will, of course, require more work.…”

Section: Discussionmentioning

confidence: 99%

How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill’s criteria for causality

Grant

2009

Dermato-Endocrinology

116

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The ultraviolet-B (UVB)-vitamin D-cancer hypothesis was proposed in 1980. Since then, several ecological and observational studies have examined the hypothesis, in addition to one good randomized, controlled trial. Also, the mechanisms whereby vitamin D reduces the risk of cancer have been elucidated. This report aims to examine the evidence to date with respect to the criteria for causality in a biological system first proposed by Robert Koch and later systematized by A. Bradford Hill. The criteria of most relevance are strength of association, consistency, biological gradient, plausibility/mechanisms and experimental verification. Results for several cancers generally satisfy these criteria. Results for breast and colorectal cancer satisfy the criteria best, but there is also good evidence that other cancers do as well, including bladder, esophageal, gallbladder, gastric, ovarian, rectal, renal and uterine corpus cancer, as well as Hodgkin's and non-Hodgkin's lymphoma. Several cancers have mixed findings with respect to UVB and/or vitamin D, including pancreatic and prostate cancer and melanoma. Even for these, the benefit of vitamin D seems reasonably strong. Although ecological and observational studies are not generally regarded as able to provide convincing evidence of causality, the fact that humanity has always existed with vitamin D from solar UVB irradiance means that there is a wealth of evidence to be harvested using the ecological and observational approaches. Nonetheless, additional randomized, controlled trials are warranted to further examine the link between vitamin D and cancer incidence, survival and mortality.

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“…The majority of studies to investigate seasonality in HL to date have utilised the date of diagnosis as a measure of disease onset (Newell et al, 1985;Douglas et al, 1996Douglas et al, , 1998. However, the highly variable time between the onset of symptoms and the date of diagnosis (lag time), which was confirmed in our analysis, means that the use of date of diagnosis as a measure of disease onset could be less reliable.…”

Section: Discussionmentioning

confidence: 99%