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Hodgkin's disease - Risk Factors

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of Hodgkin's disease.

Alternative Names

Lymphoma - Hodgkin's; Hodgkin's lymphoma; Hodgkins disease; HD

Risk Factors:

Hodgkinâ ' s disease is less common than non-Hodgkinâ ' s lymphoma. It accounts for about 11.5% of all lymphomas. According to the American Cancer Society, about 8,200 new cases of Hodgkin's disease (HD) are diagnosed in the United States each year. The exact causes of Hodgkinâ ' s disease are unknown. Research indicates that the malignant process leading to Hodgkin's disease may be triggered by a combination of environmental and genetic factors along with a susceptible immune system.

Age and Gender

Hodgkin's disease occurs most often in people ages 15 - 40 (especially in their 20s), and in people over age 55. About 10 - 15% of Hodgkinâ ' s disease cases are diagnosed in children and teenagers.

Hodgkin's disease is slightly more common among males than females. Women who get Hodgkin's disease appear to have a slightly lower risk for relapse after treatment than men.

Viral Infection

Infectious mononucleosis (“mono”), which is caused by the Epstein-Barr virus (EBV), is strongly linked with increased risk for Hodgkinâ ' s disease. Research suggests that the virus activates some pathway within the lymphocyte cell that leads to cell proliferation. However, only 1 in 1,000 patients with mononucleosis develops Hodgkin's disease. The Epstein-Barr virus itself is present in 90% of the population and, in the great majority of these cases, causes a mild infection or none at all. Very few people who have had mononucleosis go on to develop HD. Other factors must be present to trigger the malignancy.

People infected with the human immunodeficiency virus (HIV), which weakens the immune system, are also at increased risk of developing Hodgkinâ ' s disease.

Family

Hodgkin's disease runs in families in about 5% of cases. Siblings of patients have a three times higher risk than the general population.

Resources

References

American Cancer Society. Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society, 2008.

Brenner H, Gondos A, Pulte D. Ongoing improvement in long-term survival of patients with Hodgkin disease at all ages and recent catch-up of older patients. Blood. 2008;111 (6): 2977-83.

Fermé C, Eghbali H, Meerwaldt JH, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007 Nov 8;357(19):1916-27.

Horning SJ. Hodgkin’s lymphoma. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 111.

Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007 Feb 10;25(5):571-8. Epub 2007 Jan 22.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hodgkin Disease / Lymphoma. V.2.2009.

Oeffinger KC, Ford JS, Moskowitz CS, Diller LR, Hudson MM, Chou JF, et al. Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA. 2009 Jan 28;301(4):404-14.

  • Reviewed last on: 3/5/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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