Hodgkin's Disease - Risk Factors

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Risk Factors

According to the American Cancer Society, an estimated 7,350 new cases of Hodgkin's disease (HD) were diagnosed in the United States in 2005. Experts believe that the malignant process leading to Hodgkin's disease is triggered by a combination of environmental and genetic factors along with a susceptible immune system. The exact triggers, however, are unknown.

Gender and Hormonal Factors

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

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Age

Initial Risk by Age Group. Hodgkin's disease is the most common malignancy in people ages 10 to 30. The average age for developing Hodgkin's is about 28 years old. There are two periods of peak incidence in HD over a lifetime. The major peak occurs in young people between the ages of 15 and 24, with a lesser peak after age 55. The disease can, however, occur at all ages, even in children.

A 2001 Scandinavian study reported an increase in cases among young people. The rate of the disease in older people has declined, however, possibly because better diagnostic procedures are identifying elderly people with non-Hodgkin's lymphomas who would previously have been diagnosed with Hodgkin's.

Prognosis by Age Group. Studies suggest that children with Hodgkin's disease have a better outlook than adults -- particularly elderly adults. One 2000 study suggested, however, that the reason is due to better HD treatments in pediatric medical centers than in adult centers. In support of this, another 2000 study reported that when elderly patients were treated successfully for relapse they did as well as younger people. (In any case, unrelated illness would affect treatment complications and outlook in elderly people.) Some evidence, however, suggests that Hodgkin?s disease associated with the Epstein-Barr virus is more severe in the elderly (although possibly not in younger people) than other forms of HD.

Epstein-Barr Virus Infection and Infectious Mononucleosis

Young people who have had infectious mononucleosis ("mono"), which is caused by the Epstein-Barr virus (EBV), are at significantly higher risk for Hodgkin's disease. According to a 2003 study, if the malignancy develops in young people who have had mono, it does so on average about 4 years afterward, with a peak incidence at 2.5 years. The risk persists, however, for about 20 years after the infection.