Printed in U.S.A. DOI: 10.1093/aje/kwg198 Reproductive Factors in Hodgkin’s Disease in Women

Reproductive factors have been suggested to have an impact on the development of Hodgkin’s disease (HD) in women. In the San Francisco Bay Area, the authors conducted a population-based case-control study addressing the effects of reproductive experience and hormone use on HD risk. Cases were 370 women with HD diagnosed at ages 19–79 years between July 1988 and December 1994. Controls were 450 community women found through random digit dialing. Among the 312 cases and 325 controls interviewed, HD risk was related to parity versus nulliparity but only among never nursers (odds ratio (OR) = 2.2, 95 % confidence interval (CI): 1.0, 5.0). Risk was marginally related to having uterine fibroids (OR = 0.6, 95 % CI: 0.5, 1.0) and long-term versus short-term hormone use (OR = 0.7, 95 % CI: 0.4, 1.0) and was significantly related to recurrent miscarriage (OR = 2.8, 95 % CI: 1.1, 7.4). Among women aged 35–54 years, for whom the sex difference in incidence is largest, nursing decreased risk; among never nursers, a parity of 1 lowered risk and higher parity increased risk; long-term hormone use lowered risk; and recurrent miscarriage increased risk. Among women under age 35 years, endometriosis lowered HD risk; the lack of significant findings for most other variables may reflect selection bias in controls. Among older women, no significant associations were observed, although hormone use appeared to be protective. These data suggest that steroid hormones may affect HD development. case-control studies; endometriosis; Hodgkin disease; lactation; parity