REPRODUCTIVE FACTORS IN HODGKIN'S DISEASE IN WOMEN

这项以人群为基础的病例对照流行病学研究将检查 生殖因素和外源性激素的使用影响妇女的风险 何杰金氏病（HD），一种知之甚少的淋巴瘤。HD费率较低， 成年妇女比男子，特别是在生育年龄。虽然 HD的描述性流行病学表明生育具有保护作用 临床和实验数据都显示了 淋巴瘤妊娠，除产次外无生殖或同性使用因素 曾接受过HD风险评估。前两项研究 考虑到奇偶性和HO风险，发现了强烈但相反的关联。这 差异需要解决，而未探索的激素依赖性假说 现有证据提示对HD风险的影响需要评估。 具体的研究目的是：1）确定产次是否可以预防HD风险， 如果效果是长期的或暂时的（提示肿瘤抑制 （2）确定是否有其他生殖因素 独立影响HD 风险; 3）探索外源性激素使用对HD风险的影响; 4） 检查 上述风险的组织学类型的亚组; 5）控制整个 潜在的混杂因素（例如，社会阶级）。拟议的五年研究将 包括315名新诊断为组织学确诊HD妇女， 控制妇女，来自旧金山弗朗西斯科湾区的9个县。案件将 通过基于人群的肿瘤登记处确定。基于人群 将通过随机数字拨号和频率匹配识别对照 对案件的年龄，种族和电话号码地区代码和前缀。所有受试者 将亲自接受有关人口统计数据（包括社会地位）的采访; 病史;月经及生育史;生育经验 (age每次妊娠的时间、持续时间和结局;哺乳期）;和外源性 激素使用将估计与研究因素相关的相对风险 用逻辑回归方法对HD总体ND进行组织学亚型分析， 并对社会阶层和其他混杂因素进行调整。学习强度 包括：1）一个新的和可行的方法来调查的病因， 癌症，通过影响年轻人以及老年人，特别是 公共卫生问题;彻底检查对健康的影响 假设通过调查的一个完整的因素; 3）使用 基于人群的病例，对于完全、无偏倚的UGH受试者， 3-HD总体类型的倍相关风险; 4）使用基于人群的 控制，减少来自s的偏差;和5）详细关注可疑 混杂因素，

This population-based, case-control epidemiologic study will examine whethe reproductive factors and exogenous homone use affect women's risk of Hodgkin's disease (HD), a poorly understood lymphoma. HD rates are lower in adult women than men, particularly at reproductive ages. Although the descriptive epidemiology of HD suggests a protective effect of childbearing and both clinical and experimental data show an inhibitory effect of pregnancy on lymphomas, no reproductive or homone-use factors except parity have ever been evaluated regarding HD risk. The two prior studies considering parity and HO risk found strong but opposing associations. This discrepancy requires resolution, and the unexplored hypothesis of hormonal influence on HD risk suggested by existing evidence needs evaluation. Specific study aims are: 1) to detemine if parity protects against HD risk, and if the effect is long-term or temporary (suggesting tumor suppression during pregnancy);2) to determine whether other reproductive factors independently affect HD risk; 3) toexplore the effects of exogenous hormone use on HD risk; 4) to examine the above risks among histologic-type subgroups; 5) to control throughout for potential confounders (e.g., social class). The proposed 5-year study will include 315 women newly diagnosed with histologically confirmed HD, and 315 control women, from 9 counties in the San Francisco Bay Area. Cases will be ascertained through population-based tumor registries. Population-based controls will be identified by random-digit dialing, and requency-matched to cases on age, race and phone number area-code and Prefix. All subjects ill be interviewed in person about demographics (including social status); medical istory; menstrual and fertility history; reproductive experience (age at, duration of and utcome of each pregnancy; lactation); and exogenou hormone use. Relative risks assocated with study factors will be estimated with logistic regression methods for HD overall nd by histologic subtype, with adjustment for social class and other confounders. Study trengths include: 1) a new and feasible approach to investigating the etiology of a cancer hat, by affecting young as well as older persons, is of particular public health concern; thorough examination of the hormone-influence hypothesis through investigation of a full factors; 3) use of population-based cases, for complete, unbiased ugh subjects to detect 2- to 3-fold associated risks for HD overall type; 4) use of population-based controls, reducing biases from s; and 5) detailed attention to suspected confounding factors,