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APHA Scientific Session and Event Listing

Yueh Ying Han, Graduate School of Public Health, Department of Epidemiology/Center for Environmental Oncology, University of Pittsburgh/University of Pittsburgh Cancer Institute, 130 DeSoto Street, Pittsburgh, PA 15261, 412-478-9266, hany2@upmc.edu, Joel L. Weissfeld, Graduate School of Public Health: Department of Epidemiology, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, Gregg E. Dinse, Biostatistics Branch, National Institute of Environmental Health Sciences, 111 Alexander Drive, Research Triangle Park, NC 27709, David M. Umbach, Biostatistics Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, Durham, NC 27709, and Devra Lee Davis, Center for Environmental Oncology, University of Pittsburgh Cancer Institute, UPMC Cancer Pavilion, Fourth Floor, Room 435, 5150 Centre Avenue, Pittsburgh, PA 15232.

The known risk factors of hematopoietic malignancies (HMs) such as ionizing radiation, solvent and pesticide exposure, and immunosuppression explain only a small proportion of the cases. To generate etiologic hypotheses, we characterize race- and gender-specific HMs incidence in the U.S. in terms of temporal patterns associated with age, calendar year, and birth cohort. Incidence of Hodgkin's disease, non-Hodgkin's lymphoma (NHL), multiple myeloma, and leukemia were extracted from the SEER 9 registry (1975-2002), displaying age-period-cohort analyses and using SEER*Stat software to fit Joinpoint models. HMs incidence is higher in men than in women. Age-adjusted incidence of NHL is greater than that of leukemia, multiple myeloma, and Hodgkin's disease. Average annual changes for white and black men, and white and black women are: 1.0%, 1.1%, 0.9%, and 1.6%, respectively. Linear time trends do not adequately capture the temporal patterns of HMs. All four race-by-gender subgroups deviate from linearity due to age and period, though only black women appear to have nonlinear cohort effects. NHL incidence trends paralleled those of HMs, whereas incidence for leukemia, multiple myeloma, and Hodgkin's disease was constant over time. NHL rates increase significantly over time from 1975 to 2002, with greatest increases in those aged 50 and over. Age-adjusted time trends for other HMs subtypes initially increase up to 1995 and start to decrease thereafter. HIV infection and subsequent treatment could explain some of the NHL patterns of young men. The time course of NHL in older groups might be related to iatrogenic immunosuppression or to environmental exposures.

Learning Objectives:

• To verify that incidence of hematopoietic malignancies continues to increase, especially NHL.
• To distinguish gender- and race-specific incidence trends.
• To identify temporal changes in incidence associated with age, period, and cohort effects.
• To explain patterns in underlying risk factors.
• To provide clues about avoidable causes within population subgroups.

Keywords: Cancer, Epidemiology

Presenting author's disclosure statement:

Not Answered