Hodgkin's Disease - Risk Factors

EBV most likely plays a role in about half of HD cases. Research suggests that the virus activates some pathway within the lymphocyte cell that leads to cell proliferation.

Only1 in 1000 patients with mononucleosis develops Hodgkin's disease, however.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, and very few develop HD.Other factors must be present to trigger the malignancy.

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EBV appears to be more common in the mixed cellularity subtype of Hodgkin's disease and to occur less often in the nodular sclerosis subtype. In fact, there have been reports of a decline in EBV-associated HD, which coincides with an increasing incidence of nodular sclerosis HD.

Some evidence suggests that ethnic differences may be involved in a lower or higher susceptibility to Hodgkin's disease after an Epstein-Barr infection, with Northern Europeans being at higher risk than other groups.

Family and Ethnic Factors

Hodgkin's disease runs in families in about 5% of cases. Siblings have three times more risk than the general population. Studies suggest that such family clusters are more likely to be due to environmental than genetic factors.

Environmental Toxins

Although high exposure to industrial chemicals has been linked to non-Hodgkin's lymphomas, it is not clear if this is a major risk factor in HD. In a 1999 analysis of studies on the subject, woodworking posed the most consistent risk, although no specific chemical was implicated and not all studies reported a risk. In a 2000 study, automobile workers exposed to cutting oil had a much higher incidence of HD as well as cancers of the lung and testis. Dioxin may also be associated with a higher risk for HD.

Other Factors Associated with Hodgkin's Disease

There is slightly higher than normal risk for HD in people who:

Are from small families
Have higher educational levels
Comefrom homes with good hygiene
Live in developed countries
Smoke
Are HIV-positive
Have inflammatory bowel disease (ulcerative colitis or Crohn's disease) -- one study suggested that this relationship may be due to Epstein-Barr virus

Inflammatory bowel disease includes Crohn's disease and ulcerative colitis.Crohn's disease is usually confined to the end of the small intestine,called the ileum. Ulcerative colitisis a similar inflammation of the colon (large intestine).