The epidemiology of Hodgkin's disease in Newfoundland

Buehler, Sharon (1983) The epidemiology of Hodgkin's disease in Newfoundland. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

From 1954 to 1973, seven cases of Hodgkin’s disease occurred in a population of 1500 people on the west coast of Newfoundland. In contrast, published figures indicated that incidence was low in the province as a whole. This regionally high frequency of cancer within a province where Hodgkin’s disease was thought to be uncommon required clarification. -- The objectives of this thesis were to verify the low incidence with well documented figures, to critically evaluate the data sources, and to suggest possible reasons for the infrequent occurrence of this cancer in Newfoundland. -- There were four sources of data; death certificates, hospital records, radiation oncology records, and records from the cancer registry were used to collect information on every case of Hodgkin’s disease recorded in Newfoundland from 1965 to 1974. -- The main findings were 1) Hodgkin’s disease incidence in Newfoundland from 1965-74 was low; 2) typical of the Type II pattern of Hodgkin’s disease, this low incidence was associated with a relatively large number of cases in young males and with histological types with poorer prognosis; 3) patients were more likely to have worked in professional and skilled occupations and 4) were more likely to have been born in late summer; and 5) Canadian incidence was associated with standard of living while crowding appeared to be a better predictor of Newfoundland incidence. No one data set was sufficient to locate all cases or to provide all information needed. Of the errors and omissions in data sources I the most serious was the large discrepancy in the medical insurance number and the date of birth which it incorporates. -- The frequency of patient births in late summer raises the possibility of an environmental agent working at the time of conception or at birth. -- If incidence is due in part to socioeconomic factors, then the improvement in standard of living should eventually modify incidence upwards. Therefore it is suggested that Hodgkin's disease in Newfoundland is in transition to a Type III pattern providing a unique opportunity to document the environmental factors associated with this change.

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