This application requests funds for the first interview case- control study of childhood Hodgkin's disease (HD). Based on a great deal of epidemiologic research on HD, it appears that environmental exposures, particularly factors effecting likelihood of exposure to infectious agents during childhood, play an important etiologic role in young adult HD. Despite the apparent importance of childhood exposures in the etiology of HD, there has never been a study of the role of such exposures in childhood HD. This study aims to fill several important gaps in knowledge by studying environmental exposures as risk factors for childhood HD. This study will evaluate the following: whether on epidemiologic grounds, childhood HD is distinct from the young adult and old adult diseases; the hypothesis that children with HD have different patterns of infectious diseases than do matched controls; whether day-care and breast feeding, and other determinants of risk of childhood infectious diseases, affect risk of childhood HD; whether there are associations between markers of socioeconomic status and childhood HD risk; whether parental occupational exposures are risk factors for HD in their children; whether wood and chemical exposures of the child are risk factors for childhood HD; whether there is familial aggregation of HD, as well as possibly increased risks of other malignancies in case families. This study uses methods we have developed for the utilization of subjects from a collaborative therapeutic clinical trials group for etiologic research. This approach greatly facilitates studies of extremely rare cancers, such as childhood HD, by permitting relatively rapid accrual of sufficient numbers of subjects. Additionally, all cases have their diagnoses confirmed by central expert pathologic review. This approach also fosters greater interaction and exchange of ideas between epidemiologists and clinicians. Cases will be obtained from the Pediatric Oncology Group, a national collaborative clinical trials group. An expected total of 300 new cases aged 0-14 years will be accrued from all geographic areas of the U.S. over a three-year intake period. Cases and control parents will be interviewed by telephone after appropriate consent is obtained. For each case under age 10 years, three controls of the same race, sex and similar age will be selected from the same communities as cases by random-digit telephone dialing. For cases age 10-14, one control per case will be selected. An estimated 92 cases will be under the age of 10 and 208 cases will be in the age group 10-14. An estimated total of 484 controls is expected. This study will fill several important gaps in knowledge of the epidemiology of HD and can provide important new insights into the possibly infectious etiology of human cancer.
