title: Clustering of cancer among families of cases with Hodgkin Lymphoma (HL), Multiple Myeloma (MM), Non-Hodgkin's Lymphoma (NHL), Soft Tissue Sarcoma (STS) and control subjects.
abstract: BACKGROUND
  A positive family history of chronic diseases including cancer can be used as an index of genetic and shared environmental influences. The tumours studied have several putative risk factors in common including occupational exposure to certain pesticides and a positive family history of cancer.
  
  
  METHODS
  We conducted population-based studies of Hodgkin lymphoma (HL), Multiple Myeloma (MM), non-Hodgkin's Lymphoma (NHL), and Soft Tissue Sarcoma (STS) among male incident case and control subjects in six Canadian provinces. The postal questionnaire was used to collect personal demographic data, a medical history, a lifetime occupational history, smoking pattern, and the information on family history of cancer. The family history of cancer was restricted to first degree relatives and included relationship to the index subjects and the types of tumours diagnosed among relatives. The information was collected on 1528 cases (HL (n = 316), MM (n = 342), NHL (n = 513), STS (n = 357)) and 1506 age +/- 2 years and province of residence matched control subjects. Conditional logistic regression analyses adjusted for the matching variables were conducted.
  
  
  RESULTS
  We found that most families were cancer free, and a minority included two or more affected relatives. HL [(OR(adj) (95% CI) 1.79 (1.33, 2.42)], MM (1.38(1.07, 1.78)), NHL (1.43 (1.15, 1.77)), and STS cases (1.30(1.00, 1.68)) had higher incidence of cancer if any first degree relative was affected with cancer compared to control families. Constructing mutually exclusive categories combining "family history of cancer" (yes, no) and "pesticide exposure > or = 10 hours per year" (yes, no) indicated that a positive family history was important for HL (2.25(1.61, 3.15)), and for the combination of the two exposures increased risk for MM (1.69(1.14,2.51)). Also, a positive family history of cancer both with (1.72 (1.21, 2.45)) and without pesticide exposure (1.43(1.12, 1.83)) increased risk of NHL.
  
  
  CONCLUSIONS
  HL, MM, NHL, and STS cases had higher incidence of cancer if any first degree relative affected with cancer compared to control families. A positive family history of cancer and/or shared environmental exposure to agricultural chemicals play an important role in the development of cancer.
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Royal University Hospital, Saskatoon, SK, Canada. mcduffie@sask.usask.ca
authors.forename: Helen H
authors.initials: HH
authors.lastname: McDuffie
authors.forename: Punam
authors.initials: P
authors.lastname: Pahwa
authors.forename: Chandima P
authors.initials: CP
authors.lastname: Karunanayake
authors.forename: John J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: James A
authors.initials: JA
authors.lastname: Dosman
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D016000:Cluster Analysis; D005192:Family Health; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology / Q000235:genetics*; D012509:Sarcoma / Q000453:epidemiology / Q000235:genetics*; D011795:Surveys and Questionnaires