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Hodgkin lymphoma incidence statistics

Hodgkin lymphoma incidence statistics by country in the UK, age, and trends over time are presented here. There are also data by subtype, stage at diagnosis, geography and prevalence. 

Find out more about the coding and counting of this data

By country in the UK

Hodgkin lymphoma accounts for less than 1% of all cancers in the UK (2011).1-4

In 2011, there were 1,845 new cases of Hodgkin lymphoma in the UK (Table 1.1): 1,048 (57%) in males and 797 (43%) in females, giving a male:female ratio of around 13:10.1-4  The crude incidence rate shows that there are 3 new Hodgkin lymphoma cases for every 100,000 males in the UK and 3 for every 100,000 females. 

The European age-standardised incidence rates (AS rates) do not differ significantly between the constituent countries of the UK for either sex (Table 1.1).1-4

Table 1.1: Hodgkin Lymphoma (C81), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2011

England Wales Scotland Northern Ireland UK
Male Cases 861 61 102 24 1,048
Crude Rate 3.3 4.1 4.0 2.7 3.4
AS Rate 3.2 3.7 3.7 2.5 3.2
AS Rate - 95% LCL 3.0 2.7 3.0 1.5 3.0
AS Rate - 95% UCL 3.4 4.6 4.5 3.5 3.4
Female Cases 656 45 67 29 797
Crude Rate 2.4 2.9 2.5 3.1 2.5
AS Rate 2.3 2.7 2.3 2.8 2.3
AS Rate - 95% LCL 2.1 1.9 1.7 1.8 2.2
AS Rate - 95% UCL 2.5 3.5 2.8 3.9 2.5
Persons Cases 1,517 106 169 53 1,845
Crude Rate 2.9 3.5 3.2 2.9 2.9
AS Rate 2.7 3.2 3.0 2.7 2.8
AS Rate - 95% LCL 2.6 2.6 2.5 1.9 2.6
AS Rate - 95% UCL 2.9 3.8 3.4 3.4 2.9

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95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Though variation in Hodgkin lymphoma incidence across the UK has been reported,6,7 this variation appears to be mostly artefactual, reflecting differences in registration methods, diagnosis and classification.5

Hodgkin lymphoma subtypes can be divided into two broad groups: Classical Hodgkin lymphoma (ICD-10 C81.1, C81.2, C81.3) which accounted for 63% of all Hodgkin lymphoma cases diagnosed in the UK in 2009-2011, and nodular lymphocyte-predominant Hodgkin lymphoma (ICD-10 C81.0) which accounted for 10% of cases. The remaining 27% of Hodgkin lymphoma cases in the UK in 2009-2011 were of other or unspecified Hodgkin lymphoma types (ICD-10 C81.7, C81.9) (Table 1.2).1-4

Table 1.2: Hodgkin Lymphoma Subtypes, Annual Average Number of New Cases, European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2009-2011

  Classical Hodgkin lymphoma Nodular lymphocyte-predominant Hodgkin lymphoma Other and unspecified Hodgkin lymphoma
Male Cases 637 139 289
AS Rate (95% LCL-95% UCL) 2.0 (1.9-2.1) 0.4 (0.4-0.5) 0.9 (0.8-0.9)
Female Cases 539 49 222
AS Rate (95% LCL-95% UCL) 1.6 (1.6-1.7) 0.1 (0.1-0.2) 0.6 (0.6-0.7)
Persons Cases 1,176 188 511
AS Rate (95% LCL-95% UCL) 1.8 (1.8-1.9) 0.3 (0.3-0.3) 0.7 (0.7-0.8)

95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

section reviewed 16/04/14
section updated 16/04/14

 

By age

Hodgkin lymphoma incidence shows a clear bimodal age distribution, with the first peak in incidence rates in young adults, and the second peak in older men and women. In the UK between 2009 and 2011, an average of 10% of cases were diagnosed in men and women aged 75 years and over, and around a fifth (22%) were diagnosed in children, teenagers and young adults aged 24 and under (Figure 1.1).1-4

Age-specific incidence rates rise sharply during childhood and peak first in young adults aged 20-24. For females this is the highest peak. Rates then decrease until middle age before rising again to reach a second peak in men aged 75-79 and women aged 70-74. For males this is the highest peak. Incidence rates are higher for males than for females in many age groups, with the male:female incidence ratio of age-specific rates (to account for the different proportions of males to females in each age group) varying between 13:10 and 23:10. Higher ratios are found in the youngest children but these are based on a very low number of cases (Figure 1.1).1-4

Figure 1.1: Hodgkin Lymphoma (C81), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK, 2009-2011

cases_crude_hl.swf

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section reviewed 16/04/14
section updated 16/04/14

 

Trends over time

Hodgkin lymphoma incidence rates have remained stable overall for males and increased overall for females in Great Britain since the mid-1970s, though for both sexes this includes a decrease followed by an increase (Figure 1.2).1-3 For males, European AS incidence rates decreased by 24% between 1975-1977 and 1995-1997, then increased by 24% between 1995-1997 and 2009-2011. For females, rates decreased by 12% between 1975-1977 and 1989-1991, then increased by 35% between 1989-1991 and 2009-2011.

Trends in Hodgkin lymphoma incidence probably largely reflect changes in diagnosis, classification and registration practices.5,11,12

Figure 1.2: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, Great Britain, 1975-2011

inc_asr_gb_hl.swf

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Hodgkin lymphoma incidence trends for the UK are shown in Figure 1.3.1-4 Over the last decade (between 2000-2002 and 2009-2011), the European AS incidence rates have increased by 11% and 21% in males and females, respectively. 

Figure 1.3: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, UK, 1993-2011

inc_asr_uk_hl.swf

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Hodgkin lymphoma incidence rates have remained stable overall for most broad adult age groups in Great Britain since the mid-1970s, though there has been a slight increase in younger adults (Figure 1.4).1-3 In people aged 15-39, European AS incidence rates increased overall by 13% between 1975-1977 and 2009-2011, with most of this increase in the last decade. In the older age groups (40-59, 60-69, 70-79, and 80+), rates decreased between the mid-1970s and mid-1990s; and have since increased; the most pronounced changes have been in the 70-79 age group, where rates dropped by 47% between 1975-1977 and 1993-1995, then rose by 81% between 1993-1995 and 2009-2011.

Figure 1.4: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates, by Age, Great Britain, 1975-2011

inc_asr_age_p_hl.swf

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section reviewed 16/04/14
section updated 16/04/14

By stage at diagnosis

Staging for Hodgkin lymphoma most commonly uses the Ann Arbor system.8

Data by stage are not yet routinely available for the UK due to inconsistencies in the collecting and recording of staging data in the past. However this is improving and plans for a nationally consistent dataset in England are underway.9 In the meantime, incidence by stage is available for the former Anglia Cancer Network in the east of England for the period 2004-2008.10 Anglia covers around 5% of the population of England and may not be representative of the country as a whole due to differences in underlying demographic factors (such as age, deprivation or ethnicity), as well as variation in local healthcare provision standards and policies.

Over half (55%) of men and women diagnosed with Hodgkin lymphoma present at stage I or II (Table 1.3).10 For around a sixth (17%) of patients, the stage is not known.

Table 1.3: Hodgkin Lymphoma (C81), Proportion of Cases Diagnosed at Each Stage, Adults (Aged 15-99), Former Anglia Cancer Network, 2004-2008 

Stage at Diagnosis Proportion of cases
Stage I 24.4%
Stage II 30.8%
 
Stage III 15.4%
 
Stage IV 12.8%
 
Stage not known 16.7%
 

Percentages may not sum to 100 due to rounding

section reviewed 18/10/13
section updated 18/10/13

 

In Europe and worldwide

There is wide international variation in the incidence of Hodgkin lymphoma, the variation is similar for males and females (Figure 1.5).13 The highest rates are in Southern Europe and Northern America. In many parts of Asia and Africa, incidence rates for Hodgkin lymphoma are 1 per 100,000 population, with the world average being around 1.2 per 100,000 for males and 0.8 per 100,000 for females. Note, World age-standardised rates cannot be compared directly with European age-standardised rates.

Figure 1.5: Hodgkin Lymphoma (C81), World Age-Standardised Incidence Rates per 100,000 Population, World Regions, 2008 Estimates

world_inc_hl.swf

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There is some variation in the incidence of Hodgkin Lymphoma between the 27 countries of the European Union (EU) (Figure 1.6).14

Figure 1.6: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, EU-27 countries, 2008 Estimates

EU27_inc_hl.swf

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section reviewed 26/08/11
section updated 26/08/11

By socio-economic variation

Hodgkin lymphoma risk is associated with indicators of affluence in childhood including small family size, standard of maternal education and single family housing, this in turn is thought to reflect late exposure to a common (but as-yet unidentified) infectious agent.17-21

section reviewed 16/04/14
section updated 16/04/14

By ethnicity

Age-standardised rates for White males with Hodgkin lymphoma range from 2.7 to 3.0 per 100,000. Rates for Asian males are similar, ranging from 2.7 to 4.7 per 100,000 and the rates for Black males are also similar, ranging from 1.8 to 3.8 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 1.9 to 2.2 per 100,000, and rates for Asian and Black females are also similar ranging from 1.6 to 2.9 per 100,000 and 1.3 to 2.7 per 100,000 respectively.16 There appears to be no significant variation in Hodgkin lymphoma incidence by ethnicity in the UK.

Ranges are given because of the analysis methodology used to account for missing and unknown data. For Hodgkin lymphoma, 6,399 cases were identified; 17% had no known ethnicity.

Hodgkin lymphoma is more common in white people than black people, evidence from the US shows.22,23

section reviewed 16/04/14
section updated 16/04/14

Prevalence

Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 11,500 people were still alive at the end of 2006, up to ten years after being diagnosed with Hodgkin Lymphoma (Table 1.4).15

Table 1.4: Hodgkin Lymphoma (C81), One, Five and Ten year Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 792 3,497 6,536
Female 645 2,693 4,959
Persons 1,437 6,190 11,495

Download this table XLS (30KB) PPT (120KB) PDF (17KB)

Worldwide, it is estimated that there were more than 196,000 men and women still alive in 2008, up to five years after their diagnosis.13

section reviewed 17/05/13
section updated 17/05/13

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References for Hodgkin lymphoma incidence

  1. Data were provided by the Office for National Statistics on request, July 2013. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, May 2013. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, June 2013. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2013. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/.
  5. Haematological Malignancy Research Network. Haematological malignancies cancer registration in England (2004-2008). Quality appraisal comparing data from the National Cancer Data Repository (NCDR) with the population-based Haematological Malignancy Research Network (HMRN). Final Report. London: Leukaemia & Lymphoma Research; 2012.
  6. NCIN. Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  7. NCIN. Data on haemotological cancers by cancer network. England, 2001-2008 - Atlas. (Accessed January 2014)
  8. Smithers DW. Summary of papers delivered at the Conference on Staging in Hodgkin's Disease (Ann Arbor). Cancer Res 1971; 31(11):1869-70.
  9. Department of Health. Improving outcomes: a strategy for cancer. London: Department of Health; 2011.
  10. The National Cancer Registration Service, Eastern Office. Personal communication.
  11. Adamson P, Bray F, Costantini AS, et al. Time trends in the registration of Hodgkin and non-Hodgkin lymphomas in Europe. Eur J Cancer 2007;43:391-401.
  12. Roman E, Smith AG. Epidemiology of lymphomas. Histopathology 2011, 58:4–14.
  13. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr
  14. European age-standardised rates calculated by the Statistical Information Team at Cancer Research UK, 2011 using data from GLOBOCAN, IARC, version 1.2. http://globocan.iarc.fr
  15. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence (June 2010)
  16. National Cancer Intelligence Network and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. 2009.
  17. Altieri A, Castro F, Bermejo JL, et al. Number of siblings and the risk of lymphoma, leukemia, and myeloma by histopathology. Cancer Epidemiol Biomarkers Prev 2006; 15(7): 1281-6.
  18. Petridou E, Andrie E, Dessypris N, et al. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. 2009.
  19. Gutensohn NM, Shapiro DS. Social class risk factors among children with Hodgkin's Disease. International Journal of Cancer 1982; 30(4):433-5.
  20. Chang ET, Zheng T, Weir EG, et al. Childhood social environment and Hodgkin's lymphoma: new findings from a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2004;13(8):1361-70.
  21. Chatenoud L, Gallus S, Altieri A, et al. Number of siblings and risk of hodgkin's and other lymphoid neoplasms. Cancer Epidemiol Biomarkers Prev 2005; 14(2):552.
  22. Glaser SL. Black-white differences in Hodgkin's disease incidence in the United States by age, sex, histology subtype and time. Int J Epidemiol 1991; 20(1):68-75.
  23. Zaki A, N Natarajan, Mettlin CJ. Early and late survival in Hodgkin disease among whites and blacks living in the United States. Cancer 1993; 72(2):602-6.
Updated: 16 April 2014