Hodgkin lymphoma incidence in ethnic enclaves in California

Abstract

Hodgkin lymphoma (HL) incidence varies with migration and nativity, suggesting an influence of acculturation on risk. In population-based California data including 1483 Hispanic and 348 Asian/Pacific Islander (API) HL cases, we examined HL rates in residential neighborhoods classified by ethnic enclave status (measuring degree of acculturation) and socioeconomic status (SES). Rates were inversely associated with enclave intensity, although associations varied by gender and race. In females, the enclave effect was stronger in low-SES settings, but rates were higher in less-ethnic/high-SES than more-ethnic/low-SES neighborhoods – diminishing enclave intensity affected rates more than higher SES. In Hispanics, associations were modest, and only females experienced SES modification of rates; in APIs, the enclave effect was much stronger. Thus, acculturation measured by residence in ethnic enclaves affects HL rates independently of neighborhood SES but in complex patterns. Living in less-ethnic neighborhoods may increase HL rates by facilitating social isolation and other gender-specific exposures implicated in risk.

Keywords::

• Acculturation
• epidemiology
• ethnic enclave
• Hodgkin lymphoma
• immigration

Acknowledgements

The authors thank Kristine Winters and Meg McKinley for their help with this study. The collection of cancer incidence data used in this study was supported by the California Department of Health Services as part of the statewide cancer-reporting program mandated by California Health and Safety Code, Section 103885; by the National Cancer Institute's Surveillance, Epidemiology, and End Results Program under contracts N01-PC-35136 awarded to the Cancer Prevention Institute of California, N02-PC-15105 awarded to the Public Health Institute, HHSN261201000140C awarded to the Cancer Prevention Institute of California, HHSN261201000035C awarded to the University of Southern California, and HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention's National Program of Cancer Registries, under agreements U55/CCR921930-02 awarded to the Public Health Institute and U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.

Ellen T. Chang is employed by Exponent, Inc., a for-profit corporation that provides engineering and scientific consulting services to private and government organizations. As part of her employment for Exponent, Dr Chang has been a consultant on the epidemiology of HL.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.