Social class and risk of Hodgkin's disease in young‐adult women in 1988–94

Glaser, Sally L.; Clarke, Christina A.; Nugent, Rebecca A.; Stearns, Cynthia B.; Dorfman, Ronald F.

doi:10.1002/ijc.10164

Cited by 45 publications

(35 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For the case-control study, detailed elsewhere (4,19,20), the population-based Greater Bay Area Cancer Registry identified 395 women ages 19 to 79 years and living in the Greater Bay Area of northern California when newly diagnosed with HL between mid July 1988 and the end of December 1994. Institutional review boards at the Northern California Cancer Center and Stanford University approved this project and its informed consent procedures.…”

Section: Methodsmentioning

confidence: 99%

Body Size, Physical Activity, and Risk of Hodgkin's Lymphoma in Women

Keegan

Glaser

Clarke

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

Self Cite

View full text Add to dashboard Cite

Few studies have examined the associations of body size and physical activity with the development of Hodgkin's lymphoma (HL) in women. In data from a population-based case-control study in women ages 19 to 79 years, we assessed the relation of self-report height, weight, body mass index (BMI), and strenuous physical activity to HL risk in 312 cases with diagnostic re-review and 325 randomdigit dialed controls using logistic regression. Analyses were stratified by age group and tumor cell presence of EBV. After adjustment for social class measures, taller childhood and adult height were associated with higher HL risk. In women ages 19 to 44 years, HL risk was elevated for higher, but healthy, BMI values, whereas in women ages 45 to 79 years, associations with BMI were inverse. The odds of developing HL were lower with participation (versus nonparticipation) in strenuous physical activity in the past year [odds ratio (OR), 0.58; 95% confidence interval (95% CI), 0.39-0.87 in women 19-44 years; OR, 0.45; 95% CI, 0.19-1.06 in women 45-79 years] and throughout adult life, and with sports team membership (versus nonmembership) in high school and/or at ages 18 to 22 years. Results were similar in cases (n = 269) with and without tumor-cell EBV compared with controls, although the inverse association with physical activity was somewhat stronger for women with EBV-positive disease. These findings show that in women, body size and strenuous physical activity, both modifiable characteristics, are associated with HL risk in adult life possibly through immunologic, infectious, or genetic mechanisms. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1095 -101)

show abstract

Section: Methodsmentioning

confidence: 99%

Body Size, Physical Activity, and Risk of Hodgkin's Lymphoma in Women

Keegan

Glaser

Clarke

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

Self Cite

View full text Add to dashboard Cite

show abstract

“…Young adult HD patients from a high socioeconomic environment do not, however, usually have an EBV-associated disease (Alexander et al, 2000), although epidemiological evidence suggests that this age group is the one whose HD is most expected to be related to late exposure to a common infectious agent (Gutensohn and Cole, 1981;Glaser, 1990;Westergaard et al, 1997;Sleckman et al, 1998;Glaser et al, 2002). Evidence of delayed exposure to EBV is present in only a minority of these young adult HD patients (Jarrett, 2002).…”

mentioning

confidence: 99%

Measles virus: evidence of an association with Hodgkin's disease

Benharroch

Shemer‐Avni

et al. 2004

Br J Cancer

View full text Add to dashboard Cite

The quest for an infectious agent that may account for cases of Hodgkin's disease (HD) especially in young adults has proven vain until lately. We have recently reported findings that suggested the presence of measles virus (MV) antigens and MV RNA in the tissues of patients with HD. Support for an association between MV and HD has been provided by recent epidemiological findings relating the occurrence of HD to exposure to measles in pregnancy and the perinatal period. We now present further evidence of this putative association based on immunohistochemical, reverse transcriptase -polymerase chain reaction (RT -PCR) and in situ hybridisation studies (ISH) on HD tissues. Biopsies from 82 (54.3%) of our cohort of 154 patients showed a positive immunostain with at least two of the anti-measles antibodies used. Latent membrane protein-1 immunostaining for Epstein -Barr virus was positive in 46 (31.1%) of the patients examined. Reverse transcriptase -PCR and ISH for measles RNA were positive in seven and 10 of 28 patients, respectively. Preliminary clinicopathological associations between MV and HD are noted in this study, but no causal relationship can be claimed at this stage.

show abstract

“…42 (ii) In populations showing no association with HL, IM may have ceased serving as an informative proxy for relevant infectious exposures in affluent groups because of child-care and other social changes affecting children's exposure to each other, as we previously proposed. 20 In our study, the 49 nonwhite young adult HL cases, who came from less affluent populations than the white cases, 20 had a higher proportion of EBV-positive disease than white cases (20% vs. 9%) and a higher proportion reporting IM (14%) than the 51 controls (6%); among the 31 nonwhite cases with EBV-negative HL, there was a strong, suggestive association with IM (OR ¼ 3.7 95% CI 0.9-16.4). Thus, the positive association of IM and EBV-negative HL of Alexander et al 14 may reflect a study population whose socioeconomic experience is similar to that of this subset of our cases.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 Data were first examined with contingency table analyses using w 2 statistics to compare EBV-positive and EBV-negative cases to all controls. Variables of interest included social class measures that could indicate childhood exposure to children [household size (i.e., number of siblings and of unrelated children living for at least 6 months with the subject's family); birth order; bedroom sharing at ages 5, 8 and 11; number of playmates at age 8]; self-reported history of infections in the subject and, for IM, in her family (parents, siblings, children); and self-reported age at which the subject's infections occurred.…”

Section: Methodsmentioning

confidence: 99%

“…For the present analyses, we estimated ORs and 95% CIs separately for EBV-positive and EBV-negative cases compared to controls using unconditional logistic regression with SAS software (version 8.0; SAS Institute, Cary, NC). All ORs were adjusted for continuous age and race/ethnicity (white non-Hispanic or other) and, as sample sizes permitted, for previously identified age group-specific confounders; 16,[20][21][22] regression models involving bedroom sharing could include only one of the 3 bedroom-sharing variables at a time because of colinearity. Data were too sparse to stratify analyses by race/ethnicity or histologic subtype.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Exposure to childhood infections and risk of Epstein‐Barr virus–defined Hodgkin's lymphoma in women

Glaser

Keegan

Clarke

et al. 2005

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

The role of Epstein-Barr virus (EBV) in Hodgkin's lymphoma (HL) etiology remains unresolved as EBV is detected in only some HL tumors and few studies have tried to reconcile its presence with factors suggesting viral etiology (e.g., childhood social class, infection history). In a population-based case-control study of San Francisco Bay area women, we analyzed interview data by tumor EBV status. Among 211 young adult cases, EBV-positive HL (11%) was associated with a single vs. shared bedroom at age 11 (OR ¼ 4.0, 95% CI 1.1-14.4); risk was decreased for common childhood infections (OR ¼ 0.3, 95% CI 0.1-1.0), including measles before age 10, but not with prior infectious mononucleosis (IM), which is delayed EBV infection. No study factors affected risk of young adult EBV-negative HL. Among 57 older adult cases, EBV-positive HL (23%) was unrelated to study factors; EBV-negative HL was associated with a single bedroom at age 11 (OR ¼ 3.6, 95% CI 1.5-9.1) and IM in family members (OR ¼ 3.1, 95% CI 1.1-9.0). Thus, delayed exposure to infection may increase risk of EBV-positive HL in young adults, but risk patterns differ in younger and older women for both EBV-positive and -negative HL. Late EBV infection does not appear relevant to risk, suggesting that other pathogens impact HL etiology in affluent female populations. Inconsistency of findings with prior studies may reflect failure of study risk factors to proxy meaningful exposures, risk differences by gender, or selection or misclassification bias. Null findings for EBV-negative HL indicate that etiologic models should be reconsidered for this common form. ' 2005 Wiley-Liss, Inc.Key words: Hodgkin's lymphoma; Epstein-Barr virus; etiology; risk factor; infectious mononucleosis Infections have long been suspected in the etiology of HL, particularly for young adult cases. Initial clues came from its heterogeneous clinical behavior and histologic appearance, which suggest both a chronic infection and a malignancy. 1,2 Subsequently, epidemiologic studies showed that young adult HL cases tended to have childhood characteristics such as early birth order and small family size that are consistent with delayed exposure to other children, suggesting that timing of childhood infections was etiologically important. 3,4 EBV, a ubiquitous herpesvirus, was of early interest as a possible causative infectious agent because HL patients were more likely than controls to report prior IM (the clinical manifestation of primary infection with EBV delayed until adolescence) and to have elevated antibody titers to EBV before as well as after HL diagnosis. 5,6 Involvement by EBV was further supported when molecular studies identified EBV genes and gene products within malignant cells of affected HL tumors and in a form suggesting that infection preceded malignant transformation. 7 Nevertheless, the role of EBV in HL etiology remains unresolved as present methods detect evidence of EBV in the tumor cells of only a proportion of HL patients, and this evidence is least common in young adul...

show abstract

Social class and risk of Hodgkin's disease in young‐adult women in 1988–94

Cited by 45 publications

References 29 publications

Body Size, Physical Activity, and Risk of Hodgkin's Lymphoma in Women

Body Size, Physical Activity, and Risk of Hodgkin's Lymphoma in Women

Measles virus: evidence of an association with Hodgkin's disease

Exposure to childhood infections and risk of Epstein‐Barr virus–defined Hodgkin's lymphoma in women

Contact Info

Product

Resources

About