Children, Cancer, and the Environment

Lymphomas

Lymphomas are tumors in the lymph system. This system is responsible for fighting diseases in the body and is part of the immune system. Lymphomas are the third most common form of cancer in children.

There are two principal types: Hodgkin’s disease and non-Hodgkin’s lymphomas (which include lymphoblastic lymphoma and large cell lymphoma.)

The causes of these two different types of lymphomas are thought to be different.

Hodgkin’s disease becomes more common as children get older. Some proportion of cases may have genetic causes. One study estimated that as many of 28% of cases may have an inherited component (1). Infectious agents also appear to be a cause of the disease, specifically Epstein-Barr virus. Some secondary cofactor also appears to be needed to activate the virus, as infection with this virus is quite common and most people do not get the cancer (2, 3).

Non-Hodgkin's lymphoma (NHL) includes several different kinds of cancer. It is less common in children under four. It is more common in boys.

The frequency of non-Hodgkin's lymphoma (NHL) increased during the years from 1975 to 1995 for adolescents aged 15 to 19. (It also increased in young adults.) It does not appear to have increased for younger children (4).

For non-Hodgkin’s lymphoma, exposure to radiation and chemotherapy may be causes. Pesticide use may be associated with the disease as well, though only limited information is available.

A review of studies of pesticides and childhood cancer identified five studies that focused on non-Hodgkin's lymphoma (5).

·        A study of children diagnosed with cancer in the Denver area found that children who had been exposed to pesticides used for control of pests at home were at greater risk of NHL than other children (6).

·        A large study of cancer in the children of farmers in Norway found that children of parents who worked in horticulture or with pesticides had an increased risk for NHL   The risk increased with the level of expenditures on pesticides on the farm (7).

·        A US study of home pesticide use reported an increased risk of NHL in children living in homes where pest extermination had been performed after the child was born (6).

·        A study with a large number of childhood cancer cases within a defined population in Germany found that residential use of insecticides was more common in houses occupied by children with NHL than other children (8).

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References

1. Shugart YY, Hemminki K, Vaittinen P, Kingman A, Dong C. A genetic study of Hodgkin's lymphoma: an estimate of heritability and anticipation based on the familial cancer database in Sweden. Human Genetics 2000; 106:553-6.

2. Pagano JS. Epstein-Barr virus: the first human tumor virus and its role in cancer. Proceedings of the Association of American Physicians 1999; 111:573-80.

3. Stiller CA. What causes Hodgkin's disease in children? European Journal of Cancer 1998; 34:523-8.

4. Percy CL, Smith MA, Linet M, Ries LA, Friedman DL. Lymphomas and reticuloendothelial neoplasms (ICC II). In: Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young JL, Bunin GR, eds. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program 1975-1995. Bethesda Md: Cancer Statistics Branch, Cancer Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 1999:35-49.

5. Zahm SH, Ward MH. Pesticides and childhood cancer. Environmental Health Perspectives 1998; 106 Supplement 3:893-908.

6. Leiss JK, Savitz DA. Home pesticide use and childhood cancer: a case-control study. American Journal of Public Health 1995; 85:249-52.

7. Kristensen P, Andersen A, Irgens LM, Bye AS, Sundheim L. Cancer in offspring of parents engaged in agricultural activities in Norway: incidence and risk factors in the farm environment. International Journal of Cancer 1996; 65:39-50.

8. Meinert R, Schüz J, Kaletsch U, Kaatsch P, Michaelis J. Leukemia and non-Hodgkin's lymphoma in childhood and exposure to pesticides: results of a register-based case-control study in Germany. American Journal of Epidemiology 2000; 151:639-46; discussion 647-50.