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This study aimed to advance our understanding of epidemiological differences between cHL subtypes, in particular EBV\u2010positive and EBV\u2010negative cHL. We retrospectively collected and EBV\u2010typed 1992 cHL primary tumour tissues from among all 2811 patients diagnosed with incident HL in Denmark in the period 1990 through 2010 \u2018Hodgkin lymphoma in Denmark\u2019 [HOLYDAN] project. Based on characteristics of retrieved samples combined with additional information from national registers, we projected nationwide age\u2010, sex\u2010, histology\u2010 and EBV\u2010specific cHL incidence rates. The analyses demonstrated age\u2010 and sex\u2010dependent variation in histology\u2010 and EBV\u2010tumour status\u2010specific cHL incidence rates, details of which yielded new aetiological clues. cHL incidence increased markedly around the age of puberty, irrespective of histological subtype and EBV status. The incidence of all subtypes of cHL increased with age after age 50\u2009years, with the exception of EBV\u2010negative nodular sclerosis cHL in females, which therefore showed a single peak in incidence and was higher than in males among young adults. These results were obtained in a small homogeneous population and might, therefore, only apply to rich, industrialised, Western populations. Nevertheless, we propose that puberty creates an immunological host environment conducive to cHL development irrespective of EBV status and histology, and that age\u2010related decline in immune function facilitates the development of both EBV\u2010positive and EBV\u2010negative cHL.<\/jats:p>","DOI":"10.1002\/ijc.70305","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T07:15:47Z","timestamp":1766733347000},"page":"2629-2640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiological evidence for the role of puberty and immune senescence in Hodgkin lymphoma aetiology from 1992 Danish cases"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-9414","authenticated-orcid":false,"given":"Klaus","family":"Rostgaard","sequence":"first","affiliation":[{"name":"Danish Cancer Institute Danish Cancer Society  Copenhagen 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