Glaser Sally L, Chang Ellen T, Clarke Christina A, Keegan Theresa H M, Yang Juan, Gomez Scarlett Lin
a Cancer Prevention Institute of California , Fremont , CA , USA.
b Department of Health Research and Policy (Epidemiology) , Stanford University School of Medicine , Stanford , CA , USA.
Leuk Lymphoma. 2015;56(12):3270-80. doi: 10.3109/10428194.2015.1026815. Epub 2015 Jun 18.
Hodgkin lymphoma (HL) incidence varies with migration and nativity, suggesting an influence of acculturation on risk. In population-based California data including 1483 Hispanic and 348 Asian/Pacific Islander (API) HL cases, we examined HL rates in residential neighborhoods classified by ethnic enclave status (measuring degree of acculturation) and socioeconomic status (SES). Rates were inversely associated with enclave intensity, although associations varied by gender and race. In females, the enclave effect was stronger in low-SES settings, but rates were higher in less-ethnic/high-SES than more-ethnic/low-SES neighborhoods--diminishing enclave intensity affected rates more than higher SES. In Hispanics, associations were modest, and only females experienced SES modification of rates; in APIs, the enclave effect was much stronger. Thus, acculturation measured by residence in ethnic enclaves affects HL rates independently of neighborhood SES but in complex patterns. Living in less-ethnic neighborhoods may increase HL rates by facilitating social isolation and other gender-specific exposures implicated in risk.
霍奇金淋巴瘤（HL）的发病率随移民和出生地的不同而变化，这表明文化适应对患病风险有影响。在基于加利福尼亚州人口数据的研究中，我们纳入了1483例西班牙裔和348例亚太岛民（API）HL病例，研究了根据种族聚居区状况（衡量文化适应程度）和社会经济地位（SES）分类的居住社区中的HL发病率。发病率与聚居区密集程度呈负相关，不过这种关联因性别和种族而异。在女性中，低收入社会经济环境下聚居区效应更强，但在种族较少/高社会经济地位社区中的发病率高于种族较多/低社会经济地位社区——聚居区密集程度的降低对发病率的影响大于社会经济地位的提高。在西班牙裔人群中，关联程度适中，只有女性的发病率受社会经济地位影响；在亚太岛民中，聚居区效应要强得多。因此，以居住在种族聚居区来衡量的文化适应独立于社区社会经济地位影响HL发病率，但模式复杂。生活在种族较少的社区可能会因促进社会隔离以及其他与风险相关的特定性别暴露而增加HL发病率。
