Epidemiology of EBV and Hodgkin's lymphoma

The incidence of Hodgkin's disease shows marked heterogeneity with respect to age, gender, race, geographical locale, social class and histological subtype. The Epstein-Barr virus (EBV) is associated with a proportion of cases, approximately 40% in developed countries, and there is a body of evidence which suggests that mixed cellularity Hodgkin's disease is more likely to be EBV-associated than nodular sclerosis Hodgkin's disease. This study investigates the relationship between EBV and both age and histological subtype. We confirm the above subtype distribution and that childhood and older adult cases are more likely to be EBV-associated than young adult cases. Young adult nodular sclerosis cases are rarely EBV-associated providing further evidence that this is a separate disease entity. The results of this study support the multiple aetiology hypothesis which suggests that Hodgkin's disease in different age groups has different aetiologies. The epidemiology of Hodgkin's disease and studies investigating the distribution of EBV-associated cases are reviewed.