Non-Hodgkin lymphoma diagnosis and treatment statistics

Routes to diagnosis

'GP referral' is the most common route to diagnosing non-Hodgkin lymphoma

Patient Experience

Non-Hodgkin lymphoma patients rating their care very good or excellent, 2014, England

A third (33%) of non-Hodgkin lymphoma cases in England are diagnosed following a routine or urgent GP referral (but not under the ‘two-week wait’ referral route).[1] Around a third (32%) of these cases with known stage are diagnosed early (stage I or II).[2]

Around a quarter (26%) of non-Hodgkin lymphoma cases in England are diagnosed after presenting as an emergency. Almost three quarters (73%) of these cases with known stage are diagnosed late (stages III or IV).[2] 6 in 10 (60%) of emergency presentation cases are via Accident and Emergency (A&E), with the other cases coming via an emergency GP referral, inpatient referral or outpatient referral.[3]

Around a quarter (24%) of non-Hodgkin lymphoma cases in England are diagnosed via the ‘two-week wait’ referral route.[1] Almost 4 in 10 of these cases with known stage are diagnosed early (stage I or II).[2]

There are variations in routes to diagnosis by sex, age, deprivation and ethnicity.[4]

Non-Hodgkin lymphoma (C82-C85), Percentage of Cases by Route to Diagnosis, Adults Aged 15-99, England, 2012-2013

Non-Hodgkin lymphoma (C82-C85), Percentage of Cases by Stage for each Route to Diagnosis, Adults Aged (15-99), England, 2012-2013

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'14-day / Two-week wait'

England meets the standard for their country on the percentage of patients first seen by a specialist within two weeks of urgent GP referral for suspected cancer.[1]

'Two-week wait' supports early diagnosis as spotting cancer early is important for improving survival, so it is important that patients with potential cancer symptoms are referred promptly.

'31-day wait'

Wales, Scotland and Northern Ireland meet the standard for their country on the percentage of patients that receive their first cancer treatment within 31 days of a decision to treat.[2-4]

The speed at which patients receive their first treatment can have a positive outcome on their clinical outcome, so it is important that patients with cancer symptoms are treated promptly.

'62-day wait'

Wales, Scotland and Northern Ireland do not meet the standard for their country on the percentage of patients receiving their first definitive treatment for cancer within two months of a GP referral for suspected cancer.[2-4]

The speed at which patients receive their first treatment can have a positive outcome on their clinical outcome, so it is important that patients with cancer symptoms are treated promptly.

Cancer waiting times coding and standards are different in each country and so comparisons should not be made between countries, only each country against their own measures.

Haematological Cancers, Waiting Times, UK countries, 2014-15

    England Wales Scotland (lymphoma only) Northern Ireland
'14-day wait': seen by specialist following referral Performance 96.2%      
Standard 93%      
Performance against standard Meets standard      
'31-day wait': receipt of first treatment following decision to treat Performance   99.3% 99.9% 100%
Standard   98% 95% 98%
Performance against standard   Meets standard Meets standard Meets standard
'62-day wait': receipt of first treatment following referral Performance   83.8 91.8% 85.8%
Standard   95% 95% 95%
Performance against standard   Does not meet standard Does not meet standard Does not meet standard

Data not available for '14-day wait' in Wales, Scotland or NI.
Data not available for '31- or 62-day wait' in England.
Data for Scotland is for lymphoma only.

References

  1. NHS England. Cancer waiting times.  Accessed May 2015.
  2. StatsWales. Cancer waiting times. Accessed May 2015.
  3. ISD Scotland. Cancer Waiting Times. Accessed June 2015.
  4. Department of Health, Social Services and Public Safety. Cancer Waiting Times. Accessed June 2015.
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8 in 10 patients with NHL are treated with chemotherapy.[1]

Non-Hodgkin lymphoma (C82-85) First-Line Treatments, Percentage of Patients, Haematological Malignancy Research Network Region, 2004-2011

  Diffuse large B-cell lymphoma Marginal zone lymphomas Follicular lymphoma Mantle cell lymphoma Burkitt lymphoma T-cell lymphomas All lymphomas
Chemotherapy 79.5 51 32.3 66 89.7 59 58
Radiotherapy 2 11 5.8 0.5 0 3.4 4
H.pylori eradication 0 0 5.9 0 0 0 1
Photochemotherapy 0 0 0 0 0 7 0
Palliative care only/died 8.4 2.2 3.6 6.1 6.4 6.9 6.3
Support care only 6.1 1.8 7.7 5.2 3.9 9.4 6
Observation only 4 34 44.7 22.2 0 14.6 23.9

Asymptomatic marginal zone lymphomas (MZL) and follicular lymphoma (FL) patients often receive ‘observation’ when not actively treated.  Radiotherapy may be used if FL or MZL are at an early stage. 

Diffuse large B-cell lymphoma (DLBCL) and FL chemotherapy is frequently combined with immunotherapy.[2]

Many asymptomatic Mantle cell lymphoma (MCL) patients, especially the elderly and those with predominantly marrow-based disease, receive ‘observation’.

Photochemotherapy and radiotherapy will be used to treat T-cell lymphoma patients with refractory disease (therapy resistant).

Some NHL patients will receive supportive (such as blood transfusions) or palliative care if their biological age or other illnesses make them unable to withstand chemotherapy.

References

  1. Data were provided by Haematological Malignancy Research Network (HMRN), on request. Similar data can be found here: https://www.hmrn.org/.
  2. National Institute for Health and Clinical Excellence. Rituximab for aggressive non-Hodgkin's lymphoma. London: NICE; 2003
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92% of non-Hodgkin lymphoma cancer patients rate their care as ‘excellent’ or ‘very good’.[1] Patient experience varies with individual needs and concerns, which are influenced by many aspects of personal background, disease characteristics and the care environment.

84% of patients were given the name of a Clinical Nurse Specialist in charge of their care.[1] Being given the name of a Clinical Nurse Specialist in charge of a patients’ care is the factor most likely to be associated with high patient satisfaction scores.[2]

52% said they saw their GP once or twice before being told they had to go to hospital.[1] How often a patient sees their GP before being referred to hospital varies by cancer type depending on ease of diagnosis.[3]

For non-Hodgkin lymphoma the proportion that said they saw their GP once or twice before being told they had to go to hospital is lower than the average for all cancer patients.[1]

Spotting cancer early is important for improving survival so it is important that patients with potential cancer symptoms are referred for tests promptly.

Non-Hodgkin lymphoma (C C82-C85), Patient Experience Survey, by Sex, England, 2014

Female Male Persons
Percentage of patients treated for cancer who visited their GP once or twice about the health problem caused by their cancer 49.8% 54.2% 52.2%
Percentage of patients treated for cancer who said they were given the name of a Clinical Nurse Specialist in charge of their care 85.5% 83.4% 84.4%
Percentage of patients treated for cancer who rated their overall care as excellent or very good 91.5% 93.3% 92.5%

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Cancer Statistics Explained

See information and explanations on terminology used for statistics and reporting of cancer, and the methods used to calculate some of our statistics.

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