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加拿大人群中霍奇金淋巴瘤的种族与发病率

Ethnicity and incidence of Hodgkin lymphoma in Canadian population.

作者信息

Pahwa Punam, Karunanayake Chandima P, Spinelli John J, Dosman James A, McDuffie Helen H

机构信息

Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Royal University Hospital, Saskatoon, SK, Canada.

出版信息

BMC Cancer. 2009 May 11;9:141. doi: 10.1186/1471-2407-9-141.

Abstract

BACKGROUND

Research has shown that ethnicity is a significant predictor of Hodgkin lymphoma (HL). Variations in cancer incidence among ethnic groups in the same country can lead to important information in the search for etiological factors. Other risk factors important in the etiology of HL are medical history and exposure to pesticides. In this report we investigated the association between ethnicity and HL in the presence of medical history, and exposure to pesticides.

METHODS

The data resulting from a matched population-based case-control study conducted in six provinces of Canada (Ontario, Quebec, Manitoba, Saskatchewan, Alberta, and British Columbia) was analyzed to determine whether or not there was any association between ethnicity and incidence of HL when adjusted for personal medical history and pesticide exposure. Information on ethnicity, personal medical history, and pesticide exposure was collected by questionnaires via mail on 316 men diagnosed with HL; and on 1506 controls. A conditional logistic regression was utilized and results were presented as odds ratios and 95% confidence intervals.

RESULTS

In our study population, the distribution of ethnic groups was: 38.5% North American, 15% British, 8.4% Western European, 8.2% Eastern European, 1.7% Asian, 1.4% Scandinavian and 27% of other ethnic origin. Compared to North Americans (i) the risk of HL was greater among the Eastern European descendents (Odds Ratio (ORadj): 1.82; 95% confidence interval (CI): 1.02, 3.25) and Western European (ORadj: 1.62; 95% CI: 0.95-2.76) descent population (borderline significance at 5% level); and (ii) the risk of HL was lower in Asian descents. Diagnosis with measles (ORadj: 0.72, 95% C.I.: 0.53-0.98) and/or positive history of allergy desensitization shots (ORadj: 0.55, 95% C.I.: 0.30-0.99) were negatively associated with the incidence of HL, while diagnosis with acne (ORadj: 2.12, 95% C.I.: 1.19-3.78), shingles (ORadj: 2.41, 95% C.I.: 1.38-4.22) and positive family history of cancer (ORadj: 1.93, 95% C.I.: 1.40-2.65) increased the risk of HL. Exposure to individual herbicide dichlorprop showed an increased risk of HL (ORadj: 6.35, 95% C.I.: 1.56-25.92).

CONCLUSION

In Canada, compared to North Americans descendents, the risk of HL was significantly greater among the Eastern European and Western European descent population. Our results related to association between ethnicity and HL support the findings reported by other researchers. Our data showed that subjects who were diagnosed with measles or had allergy desensitization shots negatively associated with the incidence of HL; and other medical conditions, ever diagnosed with acne, and positive family history of cancer were positively associated with the incidence of HL.

摘要

背景

研究表明,种族是霍奇金淋巴瘤(HL)的一个重要预测因素。同一国家不同种族间癌症发病率的差异可为寻找病因提供重要信息。HL病因中其他重要的风险因素包括病史和接触杀虫剂。在本报告中,我们研究了在有病史和接触杀虫剂的情况下种族与HL之间的关联。

方法

对在加拿大六个省份(安大略省、魁北克省、曼尼托巴省、萨斯喀彻温省、艾伯塔省和不列颠哥伦比亚省)进行的一项基于人群的配对病例对照研究的数据进行分析,以确定在调整个人病史和杀虫剂接触情况后,种族与HL发病率之间是否存在关联。通过邮寄问卷收集了316例被诊断为HL的男性以及1506例对照的种族、个人病史和杀虫剂接触信息。采用条件逻辑回归分析,结果以比值比和95%置信区间表示。

结果

在我们的研究人群中,种族分布情况如下:北美裔占38.5%,英国裔占15%,西欧裔占8.4%,东欧裔占8.2%,亚裔占1.7%,斯堪的纳维亚裔占1.4%,其他种族裔占27%。与北美裔相比,(i)东欧裔后代患HL的风险更高(调整后比值比(ORadj):1.82;95%置信区间(CI):1.02,3.25),西欧裔后代患HL的风险也更高(ORadj:1.62;95% CI:0.95 - 2.76)(在5%水平上具有边缘显著性);(ii)亚裔后代患HL的风险较低。曾被诊断为麻疹(ORadj:0.72,95% C.I.:0.53 - 0.98)和/或有过敏脱敏注射阳性史(ORadj:0.55,95% C.I.:0.30 - 0.99)与HL发病率呈负相关,而曾被诊断为痤疮(ORadj:2.12,95% C.I.:1.19 - 3.78)、带状疱疹(ORadj:2.41,95% C.I.:1.38 - 4.22)以及有癌症家族阳性史(ORadj:1.93,95% C.I.:1.40 - 2.65)会增加患HL的风险。接触除草剂二氯丙酸显示患HL的风险增加(ORadj:6.35,95% C.I.:1.56 - 25.92)。

结论

在加拿大,与北美裔后代相比,东欧裔和西欧裔后代患HL的风险显著更高。我们关于种族与HL之间关联的结果支持了其他研究人员报告的发现。我们的数据表明,曾被诊断为麻疹或有过敏脱敏注射史的受试者与HL发病率呈负相关;而其他疾病,如曾被诊断为痤疮以及有癌症家族阳性史,则与HL发病率呈正相关。

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