Childhood Determination of Hodgkin lymphoma among U.S. servicemen
Menée aux Etats-Unis auprès de 656 militaires en service atteints d'un lymphome hodgkinien diagnostiqué entre l'âge de 17 à 32 ans, cette étude analyse les facteurs et événements survenus durant l'enfance associés au risque de lymphome à l'âge adulte
BACKGROUND:Hodgkin lymphoma (HL) in young adults is inexplicably linked to economic development METHODS: We conducted a nested case-control study of the 656 servicemen with HL diagnosed between ages 17-32 while on active duty in the U.S. military during 1950-68. Controls, chosen randomly from the servicemen on duty at the time, were matched on service, birth year, and induction date. Information came from pre-induction records and military records for the period ending at onset or the equivalent date. RESULTS: Risk was independently increased with small sib-ship size, (OR 2.3, CI 1.6-3.5) low birth order (OR1.9, CI1.4-2.6) and an interval of at least 5 years between birth and that of a previous or subsequent sibling (OR 2.1 CI1.5-3.1.) Other factors independently and significantly associated with elevated risk of HL were: tallness, high BMI, more education (but not higher income) in the County of birth, BB or AB blood type, past infectious mononucleosis, (but a deficit of other childhood viral infections). Early fatherhood conveyed high risk (OR 2.6 CI 1.4-4.8), especially if with a high-risk sibling configuration. Factors unrelated to risk included personal education, pre-induction or military occupation, induction test score, and rank. Findings were similar for nodular sclerosis and mixed cell histological subtypes. CONCLUSIONS: Protection from the environment in childhood, but not in adulthood, increases the likelihood of young adult HL, which may result from non-specific isolation from early infections and/or exposure to late infection by a specific but unidentified ubiquitous childhood virus. IMPACT: Events in childhood protect against later HL.