Hodgkin’s Lymphoma is a cancer of white blood cells. In the UK, it affects 2,000 new people each year and this number has increased by almost 20% over the last decade. The reasons for this increase are unknown. Hodgkin’s Lymphoma can occur at any age, but is most common in teenagers and young adults. Worldwide studies have shown that the age that people get Hodgkin’s Lymphoma differs between countries and is related to the country’s wealth. Wealthier countries have higher numbers of Hodgkin’s Lymphoma and it occurs later in life. It has been suggested this could be due to children in wealthy countries having more hygienic upbringing with less childhood infections. This affects their immune system development, making them more likely to develop diseases such as Hodgkin’s Lymphoma.
This study looks at age of Hodgkin’s Lymphoma diagnosis in different social classes in the UK over time to see the effect of wealth within the UK population; and, if having childhood infections or allergic diseases (asthma, hay-fever and eczema) are risk factors for developing Hodgkin’s Lymphoma. Understanding who gets Hodgkin’s Lymphoma and risk factors for developing it will help us understand why numbers are increasing and how we can address this.
Hodgkin’s Lymphoma (HL) incidence in the UK has increased by almost 20% in the last decade. The reasons for this increase are unknown. Ecological studies established that variation in age-distribution and frequency of HL worldwide are closely related to a country’s affluence level, with industrialized countries showing a later peak incidence in older adolescence/young adulthood and significantly higher HL incidence rates. This difference is thought to be attributable to variation in childhood exposure to infection, with children in wealthier countries being exposed to fewer infections at an earlier age, which affects their immune development and subsequent risk of developing certain diseases, including atopic diseases as demonstrated in the hygiene hypothesis.
This study will use general practice data, linked to hospital episode statistics and the National Cancer Registry, to investigate if age-specific HL incidence varies between different socioeconomic groups in the UK and if this has changed over time with changing affluence of the UK population. Using a case-control study design and multivariable logistic regression, odds of prior exposure to childhood infections and atopic diseases will then be compared in individuals with and without HL, matched for age and sex. This will allow determination of risk factors for developing Hodgkin’s Lymphoma.
A new diagnosis of Hodgkin’s Lymphoma (HL) at any age between 1987-2016. Early HL, defined as a new diagnosis of Hodgkin Lymphoma made before the age of 50 between 1987-2016.
Andrew Hayward - Chief Investigator - University College London ( UCL )
Meenakshi (Meena) Rafiq - Corresponding Applicant - UCL Hospital
Arturo Gonzalez-Izquierdo - Collaborator - University College London ( UCL )
Bethany Wickramsinghe - Collaborator - University College London ( UCL )
Charlotte Warren-Gash - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Georgios Lyratzopoulos - Collaborator - University College London ( UCL )
Sara Thomas - Collaborator - Not from an Organisation
Spiros Denaxas - Collaborator - University College London ( UCL )
HES Admitted Patient Care;NCRAS Cancer Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation