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Risk of Hodgkin's disease and other cancers after infectious mononucleosis.

Abstract

BACKGROUND

Infectious mononucleosis, which is caused by the Epstein-Barr virus, has been associated with an increased risk for Hodgkin's disease. Little is known, however, about how infectious mononucleosis affects long-term risk of Hodgkin's disease, how this risk varies with age at infectious mononucleosis diagnosis, or how the risk for Hodgkin's disease varies in different age groups. In addition, the general cancer profile among patients who have had infectious mononucleosis has been sparsely studied.

METHODS

Population-based cohorts of infectious mononucleosis patients in Denmark and Sweden were followed for cancer occurrence. The ratio of observed-to-expected numbers of cancers (standardized incidence ratio [SIR]) served as a measure of the relative risk for cancer. SIRs of Hodgkin's disease in different subsets of patients were compared with the use of Poisson regression analysis. All statistical tests including the trend tests were two-sided.

RESULTS

A total of 1381 cancers were observed during 689 619 person-years of follow-up among 38 562 infectious mononucleosis patients (SIR = 1. 03; 95% confidence interval [CI] = 0.98-1.09). Apart from Hodgkin's disease (SIR = 2.55; 95% CI = 1.87-3.40; n = 46), only skin cancers (SIR = 1.27; 95% CI = 1.13-1.43; n = 291) occurred in statistically significant excess. In contrast, the SIR for lung cancer was reduced (SIR = 0.71; 95% CI = 0.58-0.86; n = 102). The SIR for Hodgkin's disease remained elevated for up to two decades after the occurrence of infectious mononucleosis but decreased with time since diagnosis of infectious mononucleosis (P: for trend <.001). The SIR for Hodgkin's disease tended to increase with age at diagnosis of infectious mononucleosis (P: for trend =.05). Following infectious mononucleosis, the SIR for Hodgkin's disease at ages 15-34 years was 3.49 (95% CI = 2.46-4.81; n = 37), which was statistically significantly higher than the SIR for any other age group (P: for difference =.001).

CONCLUSION

The increased risk of Hodgkin's disease after the occurrence of infectious mononucleosis appears to be a specific phenomenon.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. hhj@ssi.dk

    , , , , , , , , ,

    Source

    Journal of the National Cancer Institute 92:18 2000 Sep 20 pg 1522-8

    MeSH

    Adolescent
    Adult
    Age Factors
    Child
    Denmark
    Female
    Hodgkin Disease
    Humans
    Incidence
    Infectious Mononucleosis
    Male
    Neoplasms
    Poisson Distribution
    Risk
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10995808

    Citation

    Hjalgrim, H, et al. "Risk of Hodgkin's Disease and Other Cancers After Infectious Mononucleosis." Journal of the National Cancer Institute, vol. 92, no. 18, 2000, pp. 1522-8.
    Hjalgrim H, Askling J, Sørensen P, et al. Risk of Hodgkin's disease and other cancers after infectious mononucleosis. J Natl Cancer Inst. 2000;92(18):1522-8.
    Hjalgrim, H., Askling, J., Sørensen, P., Madsen, M., Rosdahl, N., Storm, H. H., ... Melbye, M. (2000). Risk of Hodgkin's disease and other cancers after infectious mononucleosis. Journal of the National Cancer Institute, 92(18), pp. 1522-8.
    Hjalgrim H, et al. Risk of Hodgkin's Disease and Other Cancers After Infectious Mononucleosis. J Natl Cancer Inst. 2000 Sep 20;92(18):1522-8. PubMed PMID: 10995808.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of Hodgkin's disease and other cancers after infectious mononucleosis. AU - Hjalgrim,H, AU - Askling,J, AU - Sørensen,P, AU - Madsen,M, AU - Rosdahl,N, AU - Storm,H H, AU - Hamilton-Dutoit,S, AU - Eriksen,L S, AU - Frisch,M, AU - Ekbom,A, AU - Melbye,M, PY - 2000/9/21/pubmed PY - 2001/2/28/medline PY - 2000/9/21/entrez SP - 1522 EP - 8 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 92 IS - 18 N2 - BACKGROUND: Infectious mononucleosis, which is caused by the Epstein-Barr virus, has been associated with an increased risk for Hodgkin's disease. Little is known, however, about how infectious mononucleosis affects long-term risk of Hodgkin's disease, how this risk varies with age at infectious mononucleosis diagnosis, or how the risk for Hodgkin's disease varies in different age groups. In addition, the general cancer profile among patients who have had infectious mononucleosis has been sparsely studied. METHODS: Population-based cohorts of infectious mononucleosis patients in Denmark and Sweden were followed for cancer occurrence. The ratio of observed-to-expected numbers of cancers (standardized incidence ratio [SIR]) served as a measure of the relative risk for cancer. SIRs of Hodgkin's disease in different subsets of patients were compared with the use of Poisson regression analysis. All statistical tests including the trend tests were two-sided. RESULTS: A total of 1381 cancers were observed during 689 619 person-years of follow-up among 38 562 infectious mononucleosis patients (SIR = 1. 03; 95% confidence interval [CI] = 0.98-1.09). Apart from Hodgkin's disease (SIR = 2.55; 95% CI = 1.87-3.40; n = 46), only skin cancers (SIR = 1.27; 95% CI = 1.13-1.43; n = 291) occurred in statistically significant excess. In contrast, the SIR for lung cancer was reduced (SIR = 0.71; 95% CI = 0.58-0.86; n = 102). The SIR for Hodgkin's disease remained elevated for up to two decades after the occurrence of infectious mononucleosis but decreased with time since diagnosis of infectious mononucleosis (P: for trend <.001). The SIR for Hodgkin's disease tended to increase with age at diagnosis of infectious mononucleosis (P: for trend =.05). Following infectious mononucleosis, the SIR for Hodgkin's disease at ages 15-34 years was 3.49 (95% CI = 2.46-4.81; n = 37), which was statistically significantly higher than the SIR for any other age group (P: for difference =.001). CONCLUSION: The increased risk of Hodgkin's disease after the occurrence of infectious mononucleosis appears to be a specific phenomenon. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/10995808/full_citation L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10995808.ui DB - PRIME DP - Unbound Medicine ER -