HODGKINS-DISEASE IN CHILDREN IN THE WEST-MIDLANDS, 1957-1986 - A LARGE POPULATION-BASED STUDY

One hundred forty-one children were diagnosed with Hodgkin's disease b etween 1957 and 1986 in the West Midlands Health Authority Region (199 1 population, 1.1 million children). Eighty-seven were boys and 54 wer e girls, representing a significant male:female ratio of 1.5:1 (P < 0. 01). The average age-standardized incidence rate was 3.6 per million p er year with a significant increase in the older age group (greater-th an-or-equal-to 10 years) in the second half of the period (P = 0.02). The mixed cellularity subtype was more common in those younger than 10 years, with nodular sclerosing disease being seen more in those less- than-or-equal-to 10 years. Overall survival at 5 years was 76% (65% at 10 years) with a significant difference (P < 0.001) in survival betwe en the first and last decades. There were six second malignancies, fiv e of which could have been treatment related. A positive history of ca ncer in close relatives was found in 11 patients, and higher social cl ass was found in more older than younger children. These findings supp ort the hypothesis that Hodgkin's disease may have a viral etiology an d may be linked with socioeconomic conditions.