1. Social deprivation & gender affect incidence of Hodgkin lymphoma in children & young adults Dr Richard J.Q. McNally, Reader in Epidemiology, Institute of Health and Society, Newcastle University Richard.McNally@ncl.ac.uk

2. Introduction We do not have a clear understanding of the causes of Hodgkin lymphoma (HL) in children & young people (ages 0-24 years) Better understanding by focus on subtypes 2 aims: Examine incidence of HL subtypes by age & sex Assess possible associations with area-level socioeconomic deprivation

3. Methods Data on cases extracted from specialist registry from northern England – population 2.6 million, 30,000 births / year 621 cases of HL diagnosed in 0-24 year olds from 1968 to 2003 Population & socio-demographic data obtained from censuses Calculated rates & used statistical models to investigate associations with deprivation

4. Results Subtypes – nodular sclerosis (NS) = 247, mixed cellularity = 105, lymphocyte rich = 58, others = 68, Not Otherwise Specified (NOS) = 143 Overall HL more common in males HOWEVER, reversal for NS aged 20-24 – with 72 females & 55 males

5. Continued Deprivation calculated using 4 components of the Townsend deprivation score Decreased incidence of NS subtype among patients living in areas with more overcrowded households For NOS – reverse seen – but may be a chance finding as heterogeneous group No effect for other groups

6. Conclusions Results for NS subtype suggest that recurrent infections in exposed children may provide protection against this type of HL The female excess at age 20-24 years is also very interesting – suggests that oestrogens may be responsible in some way Further research is needed – such as case- control or epigenetic studies

7. Thank you North of England Children’s Cancer Research Fund – for providing financial support Professor Mehmet Tevfik Dorak (co-author) – Liverpool Hope University