Hodgkin lymphoma risk

Preventable cases

Hodgkin lymphoma cases are preventable, UK, 2015

 

Caused by infections

Hodgkin lymphoma cases caused by infections, UK, 2015

 

The estimated lifetime risk of being diagnosed with Hodgkin lymphoma is 1 in 360 (less than 1%) for males, and 1 in 505 (less than 1%) for females born after 1960 in the UK.[1]

These figures have been calculated on the assumption that the possibility of having more than one diagnosis of Hodgkin lymphoma over the course of a lifetime is very low (‘Current Probability’ method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on Office for National Statistics (ONS) 2016-based Life expectancies and population projections. Accessed December 2017, and Smittenaar CR, Petersen KA, Stewart K, Moitt N. Cancer Incidence and Mortality Projections in the UK Until 2035. Brit J Cancer 2016. 
  2. Esteve J, Benhamou E and Raymond L. Descriptive epidemiology. IARC Scientific Publications No.128, Lyon, International Agency for Research on Cancer, pp 67-68 1994. 

About this data

Data is for UK, past and projected cancer incidence and mortality and all-cause mortality rates for those born in 1961, ICD-10 C81.

The calculations used past and projected cancer incidence and mortality and all-cause mortality rates for those born in 1961 to project risk over the lifetime of those born in 1961 (cohort method).[1] Projections are based on observed incidence and mortality rates and therefore implicitly include changes in cancer risk factors, diagnosis and treatment.

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40% of Hodgkin lymphoma cases in the UK are preventable.[1]

Hodgkin lymphoma risk is associated with a number of risk factors.

Hodgkin Lymphoma Risk Factors

Increases risk ('sufficient' or 'convincing' evidence) May increase risk ('limited' or 'probable' evidence) Decreases risk ('sufficient' or 'convincing' evidence) May decrease risk ('limited' or 'probable' evidence)
  • Epstein-Barr virus
  • HIV

-

-

-

International Agency for Research on Cancer (IARC) classification. World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classification does not include Hodgkin lymphoma because it is not generally recognised to have a relationship to food, nutrition, and physical activity

References

  1. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018. 
  2. Cogliano VJ, Baan R, Straif K, et al. Preventable Exposures Associated With Human Cancers. JNCI 2011;103(24):1827-39.
  3. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018. 
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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 40% of Hodgkin lymphoma cases in the UK are caused by Epstein-Barr virus (EBV) infection.[2]

Infectious mononucleosis (IM, commonly known as glandular fever) is a common manifestation of EBV infection.[3] Hodgkin lymphoma risk is 2.6-6 times higher in people with a history of IM, cohort studies have shown.[3-5] The association appears to be limited to EBV-positive Hodgkin lymphoma, and Hodgkin lymphoma is diagnosed on average 3-4 years after IM, Nordic studies show.[3-6]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1]

Hodgkin lymphoma risk is 11 times higher in people with human immunodeficiency virus (HIV) compared with the general population, meta-analyses have shown.[2,3]

Among people with HIV, Hodgkin lymphoma risk is nearly 3 times higher in those with AIDS versus those without.[2] Hodgkin lymphoma in HIV may be part of an immune reconstitution syndrome, whereby risk is higher in those who have enough functioning immune cells to ‘recruit’ to Hodgkin lymphoma development, but not enough to halt that development.[4]

The association with HIV may partly reflect increased Epstein-Barr virus (EBV) incidence in the HIV-infected population, though HIV/AIDS-related decreased immune function is thought to also impact Hodgkin lymphoma risk independently.[2]

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Hodgkin lymphoma risk is around 3 times higher in first-degree relatives Open a glossary item of Hodgkin lymphoma patients, a pooled analysis showed.[1] Risk is higher when the affected relative is younger, and is higher in siblings of affected relatives (rather than parents), particularly males.[1]

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Rheumatoid arthritis

Hodgkin lymphoma risk is 3.2 times higher in people with rheumatoid arthritis compared with the general population, a meta-analysis showed.[1]

Systemic lupus erythematosus

Hodgkin lymphoma risk is 3 times higher in people with systemic lupus erythematosus compared with the general population, meta-analyses have shown.[2,3]

Sjögren’s syndrome

Hodgkin lymphoma risk is 4-5 times higher in people with Sjögren’s syndrome compared with the general population, cohort studies have shown.[4,5]

Sarcoidosis

Hodgkin lymphoma risk is 4-10 times higher in people with sarcoidosis compared with the general population, cohort studies have shown.[4,5]

References

  1. Simon TA, Thompson A, Gandhi KK, et al. Incidence of malignancy in adult patients with rheumatoid arthritis: a meta-analysis. Arthritis Res Ther. 2015 Aug 15;17:212.
  2. Cao L, Tong H, Xu G, et al. Systemic lupus erythematous and malignancy risk: a meta-analysis. PLoS One. 2015 Apr 17;10(4):e0122964.
  3. Apor E, O'Brien J, Stephen M, Castillo JJ. Systemic lupus erythematosus is associated with increased incidence of hematologic malignancies: a meta-analysis of prospective cohort studies. Leuk Res 2014;38(9):1067-71.
  4. Fallah M, Liu X, Ji J, Försti A, Sundquist K, Hemminki K. Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype. Ann Oncol. 2014;25(7):1397-404.
  5. Kristinsson SY, Landgren O, Sjöberg J, et al. Autoimmunity and risk for Hodgkin's lymphoma by subtype. Haematologica 2009;94(10):1468-9.
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Hodgkin lymphoma risk is 10-15% higher in ever-smokers, compared with never-smokers, meta- and pooled-analyses have shown.[1-3] The association may be limited to current smokers,[2,3] with a dose-response effect.[1,3] It may be limited to, or stronger in, men and older patients.[2,3] Among current smokers the association may be limited to mixed cellularity and Epstein-Barr virus (EBV)-positive classical subtypes.[2]

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