Social deprivation & gender affect incidence of Hodgkin lymphoma

in children & young adults Dr Richard J.Q. McNally,Reader in Epidemiology,

Institute of Health and Society, Newcastle University

Richard.McNally@ncl.ac.uk

Introduction

• We do not have a clear understanding of the causes of Hodgkin lymphoma (HL) in children & young people (ages 0-24 years)

• Better understanding by focus on subtypes

• 2 aims:• Examine incidence of HL subtypes by age & sex• Assess possible associations with area-level

socioeconomic deprivation

Methods

• Data on cases extracted from specialist registry from northern England – population 2.6 million, 30,000 births / year

• 621 cases of HL diagnosed in 0-24 year olds from 1968 to 2003

• Population & socio-demographic data obtained from censuses

• Calculated rates & used statistical models to investigate associations with deprivation

Results

• Subtypes – nodular sclerosis (NS) = 247, mixed cellularity = 105, lymphocyte rich = 58, others = 68, Not Otherwise Specified (NOS) = 143

• Overall HL more common in males• HOWEVER, reversal for NS aged 20-24 – with

72 females & 55 males

Continued

• Deprivation calculated using 4 components of the Townsend deprivation score

• Decreased incidence of NS subtype among patients living in areas with more overcrowded households

• For NOS – reverse seen – but may be a chance finding as heterogeneous group

• No effect for other groups

Conclusions

• Results for NS subtype suggest that recurrent infections in exposed children may provide protection against this type of HL

• The female excess at age 20-24 years is also very interesting – suggests that oestrogens may be responsible in some way

• Further research is needed – such as case-control or epigenetic studies

Thank you

• North of England Children’s Cancer Research Fund – for providing financial support

• Professor Mehmet Tevfik Dorak (co-author) – Liverpool Hope University