Incidence of Hodgkin's disease in Nordic countries

Hjalgrim, Henrik; Askling, Johan; Pukkala, Eero; Hansen, Svein; Munksgaard, Lars; Frisch, Mørten

doi:10.1016/s0140-6736(01)05498-8

Cited by 53 publications

(46 citation statements)

References 4 publications

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“…We used an age at diagnosis of 40 years as a cutoff point for early onset versus late onset in probands. This cutoff age reflects the bimodal age distribution observed among patients with HL in the Nordic countries 19 and in the United States, 2 where agespecific incidence rates increase in early adulthood and then decline rapidly to a nadir at about age 40 years before rising again with increasing age. Data were analyzed for each population both separately and in a pooled manner.…”

Section: Discussionmentioning

confidence: 84%

Familial aggregation of Hodgkin lymphoma and related tumors

Goldin

Pfeiffer

Gridley

et al. 2004

Cancer

156

100

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BACKGROUND The importance of genetic factors in the etiology of Hodgkin lymphoma (HL) has been suggested by family and population studies. However, the spectrum of malignancies associated with common genetic etiology and the effects of gender and age on familial risk have not been established. METHODS Diagnoses of lymphoproliferative malignancies were compared in 15,799 first‐degree relatives of 5047 patients with HL versus 32,117 first‐degree relatives of 10,078 control probands from Sweden and in 7185 first‐degree relatives of 2429 patients with HL versus 27,434 first‐degree relatives of 8,495 control probands from Denmark using marginal survival models. RESULTS The risk of HL in relatives of patients with HL was increased significantly in both populations, with relative risks of 3.47 (95% confidence interval [95% CI], 1.77–6.80) in Sweden and 2.55 (95% CI, 1.01–6.45) in Denmark and a pooled estimate of 3.11 (95%CI, 1.82–5.29). In Sweden, risks for relatives of patients also were increased significantly for chronic lymphocytic leukemia and non‐Hodgkin lymphoma (in males). Relative risks were higher in males compared with females and in siblings of patients compared with parents and offspring of patients. Relatives of patients with earlier‐onset disease were at higher risk for HL. CONCLUSIONS HL has an important familial component, which is stronger in families of affected individuals age < 40 years, in males, and in siblings, and it is shared with some (but not other) lymphoproliferative malignancies. The cumulative lifetime risks are very small, however, for the development of HL de novo or in first‐degree relatives of affected patients. Cancer 2004. Published 2004 by the American Cancer Society.

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Section: Discussionmentioning

confidence: 84%

Familial aggregation of Hodgkin lymphoma and related tumors

Goldin

Pfeiffer

Gridley

et al. 2004

Cancer

156

100

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“…Although the reasons for this decline are obscure, Hjalgrim et al noticed a significantly decreased incidence of non-nodular sclerosis subtypes and unspecified HL in the age group of 40 years and above during 1978-1997, and suggested that changes in diagnostic procedures may have contributed to the observed decline. 50 Concomitantly, there was a smaller slow but significant increase in incidence among adolescents and young adults, which was reported to occur primarily for HL of the nodular sclerosis subtype. 50 In good agreement with previous observations, the age-adjusted HL incidence was higher in men 51 and we also found a significantly better survival for women when adjusted for age and calendar period.…”

Section: Discussionmentioning

confidence: 97%

“…50 Concomitantly, there was a smaller slow but significant increase in incidence among adolescents and young adults, which was reported to occur primarily for HL of the nodular sclerosis subtype. 50 In good agreement with previous observations, the age-adjusted HL incidence was higher in men 51 and we also found a significantly better survival for women when adjusted for age and calendar period. 30 In the present study, when calculating RSR estimates, we compared survival among all Swedish HL patients with the total Swedish population as a reference group.…”

Section: Discussionmentioning

confidence: 97%

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Sjøberg

Halthur

Kristinsson

et al. 2012

Blood

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In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N ‫؍‬ 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009 IntroductionOver the past 40 years, major advances have been made in the management of patients with Hodgkin lymphoma (HL). These include the introduction of more accurate radiotherapy, effective multiagent chemotherapy, immunotherapy, improved staging procedures, and important developments in supportive measures for myelosuppression and infectious and other complications. 1 Therefore, HL has gone from being an invariably fatal disorder to one of the few malignancies that are now highly curable. This is particularly true for patients with early-stage disease, but today disease control rates also exceed 70% in patients presenting with high-risk features. 2 This therapeutic success has unfortunately been darkened by elevated risks of secondary primary cancers, cardiovascular disease (CVD), cerebrovascular disease, and infections in longterm HL survivors. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] CVD has been reported to be the most important cause of excess mortality after HL and second malignancies. [10][11][13][14] During the last 2-3 decades, treatment strategies have been and are being adapted based on increased knowledge of treatment-related morbidity and mortality. Awaiting novel and less toxic targeted therapies of HL, the largest potential for improving survival and healthrelated quality of life in long-term survivors 17 is by reducing the excess morbidity and mortality from causes other than HL. To evaluate progress in long-term outcome, we studied patient survival among all 6949 HL patients diagnosed in Sweden between 1973 and 2009 and followed up for death to the end of 2010. Our aim was to assess trends in patient survival and long-term excess mortality in the entire population during this 37-year period starting when curative treatment principles were well-established. Methods Central registers and patientsInformation regarding patients diagnosed with a malignant disorder in Sweden is reported to a population-based nationwide Swedish Cancer Register that was established in 1958. The register contains information on diagnosis, sex, date of birth, date of diagnosis, and the hospital where the diagnosis was made, 18-19 but does not contain detailed clinical information such as symptoms, routine laboratory tests, treatment, or comorbidities.In Sweden, every physician and pathologist/cytologist is obliged by law to report each occurrence of cancer to the registry. All deaths are recorded in the nationwide causes of death register. Each person in Sweden is given a unique national registration number used to index a...

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“…1 Although current treatment strategies manage to cure more than 80% of these patients, a substantial proportion still experience relapsing or refractory disease which eventually leads to their death. In order to identify those patients who need novel treatment strategies, several scoring systems have been proposed, including the International Prognostic Score (IPS).…”

Section: Introductionmentioning

confidence: 99%

Tumor-infiltrating macrophages correlate with adverse prognosis and Epstein-Barr virus status in classical Hodgkin's lymphoma

Bendix²,

et al. 2010

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BackgroundClassical Hodgkin's lymphoma is characterized by a minority of neoplastic cells surrounded by a heterogeneous background population of non-neoplastic cells including lymphoma-associated macrophages. High levels of expression of both the monocyte/macrophage lineage-associated antigens CD68 and CD163 have been suggested to have pro-tumor effects. The aim of our study was to correlate expression of CD68 and CD163 with the clinico-pathological features and prognosis of a cohort of patients with previously untreated Hodgkin's lymphoma. Design and MethodsA tissue microarray was constructed from paraffin-embedded tumor tissues from 288 cases of classical Hodgkin's lymphoma. CD68 and CD163 expression was assessed immunohistochemically and the degree of macrophage infiltration within the tumor was scored using point grid counting. Clinical data were obtained from clinical records. ResultsThe patients' median age was 37 years (range, 6-86 years). The male to female ratio was 1.2. In classical Hodgkin's lymphoma (n = 288) high CD68 and CD163 expression correlated, at the univariate level, with poorer overall survival (P=0.002 and P=0.03, respectively) and event-free survival (P=0.03 and P=0.04, respectively). At the multivariate level, high CD68 expression remained significantly predictive of overall survival (P=0.004). In addition, we demonstrated that both high CD68 and CD163 expression were associated with the presence of Epstein-Barr virus in the neoplastic cells (P=0.001 and P=0.0002, respectively). ConclusionsIn classical Hodgkin's lymphoma, high expression of the macrophage/monocyte-related antigens CD68 and CD163 correlates with adverse outcome and with the presence of Epstein-Barr virus in the tumor cell population.

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Incidence of Hodgkin's disease in Nordic countries

Cited by 53 publications

References 4 publications

Familial aggregation of Hodgkin lymphoma and related tumors

Familial aggregation of Hodgkin lymphoma and related tumors

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Tumor-infiltrating macrophages correlate with adverse prognosis and Epstein-Barr virus status in classical Hodgkin's lymphoma

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