Non-Hodgkin lymphoma incidence statistics

Non-Hodgkin lymphoma (NHL) (all subtypes combined) is the fifth most common cancer in the UK (2014), accounting for 4% of all new cases. In males, it is the seventh most common cancer (4% of the male total), whilst it is the seventh in females (3%).[1-4]

In 2014 there were 13,605 new cases of non-Hodgkin lymphoma in the UK: 7,514 (55%) in males and 6,091 (45%) in females, giving a male:female ratio of around 12:10.[1-4] The crude incidence rate  shows that there are 24 new NHL cases for every 100,000 males in the UK, and 19 for every 100,000 females.

For both sexes, the European age-standardised incidence rates (AS rate) are significantly higher in England compared to Scotland.For males only, the rate is significantly higher in England compared to Wales.[1-4] Rates do not differ significantly between the other constituent countries of the UK for either sex.[1-4]

Non-Hodgkin Lymphoma (C82-C86), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2014

For non-Hodgkin lymphoma, there are few established risk factors therefore differences between countries largely reflect differences in diagnosis and data recording.

The term ‘non-Hodgkin lymphoma’ describes a large group of lymphoma subtypes, which differ substantially in their cellular origin and clinical behaviour. The subtypes can be broadly divided into B-cell lymphomas, T-cell lymphomas, and lymphoproliferative disorders not otherwise specified. B-cell lymphomas can be further divided into five main types: diffuse large B-cell lymphoma, marginal zone lymphomas, follicular lymphoma, mantle cell lymphoma, and Burkitt lymphoma. It is important to recognise the homogeneity of these subtypes when interpreting statistics on NHL as a whole. The Haematological Malignancy Research Network provides detailed incidence statistics for NHL subtypes.

Non-Hodgkin lymphoma (NHL) (all subtypes combined) incidence is strongly related to age, with the highest incidence rates being in older males and females. In the UK in 2012-2014, on average each year around half (49%) of cases were diagnosed in people aged 70 and over.[1-4]

Age-specific incidence rates rise steeply from around age 50-54, reaching an overall peak in the 85-89 age group for both males and females, and subsequently dropping. Incidence rates are higher for males than females for those aged between 0-4 and 15-19, and 25-29 and over, and this gap is widest at the ages of 5 to 9, when the male: female ratio of age-specific incidence rates (to account for the different proportions of males to females in each age group) is around 28:10.[1-4]

Non-Hodgkin Lymphoma (C82-C86), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2012-2014

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For NHL, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health.

The term 'non-Hodgkin lymphoma' describes a large group of lymphoma subtypes, which differ substantially in their cellular origin and clinical behaviour. The subtypes can be broadly divided into B-cell lymphomas, T-cell lymphomas, and lymphoproliferative disorders not otherwise specified. B-cell lymphomas can be further divided into five main types: diffuse large B-cell lymphoma, marginal zone lymphomas, follicular lymphoma, mantle cell lymphoma, and Burkitt lymphoma. It is important to recognise the homogeneity of these subtypes when interpreting statistics on NHL as a whole. The Haematological Malignancy Research Network provides detailed incidence statistics for NHL subtypes.

Non-Hodgkin lymphoma (NHL) (all subtypes combined) incidence rates have increased by 39% in the UK since the early 1990s.[1-4] Non-Hodgkin lymphoma incidence rates increased by 78% (persons) in Great Britain between 1979-1981 and 1991-1993.[1-3]

For males, European age-standardised (AS) incidence rates have increased by more than a third (36% increase) between 1993-1995 and 2012-2014. This rise is similar for females, with rates having increased by 40% between 1993-1995 and 2012-2014.

Over the last decade in the UK (between 2003-2005 and 2012-2014), NHL AS incidence rates have increased by 16% for males and females combined, with a similar increase in males (17%) and females (15%).[1-4]

Non-Hodgkin Lymphoma (C82-C86), European Age-Standardised Incidence Rates, UK, 1993-2014

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NHL incidence rates have increased for most of the broad age groups in the UK since the early 1990s.[1-4] The largest increase has been in people aged 80+, with European AS incidence rates rising by 64% between 1993-1995 and 2012-2014.

Non-Hodgkin lymphoma (C82-C86), European Age-Standardised Incidence Rates, By Age, Persons, UK, 1993-2014​

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For non-Hodgkin lymphoma, like most cancer types, incidence trends largely reflect changing prevalence of risk factors and improvements in diagnosis and data recording. Recent incidence trends are influenced by risk factor prevalence in years past, and trends by age group reflect risk factor exposure in birth cohorts.

Staging completeness for non-Hodgkin lymphoma is moderate in England, with 78% of non-Hodgkin lymphoma cases recorded with a known stage at diagnosis in 2014.[1]

Non-Hodgkin Lymphoma (C82-C85), Proportion of Cases Diagnosed at Each Stage, England 2014

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People diagnosed with non-Hodgkin lymphoma with a known stage most commonly present at stage IV (45%), in England. More people with a known stage are diagnosed at an advanced stage (64% diagnosed at stage III or IV) than an early stage (36% diagnosed at stage I or II ).[1]

Non-Hodgkin lymphoma (NHL) incidence rates are projected to fall by 2% in the UK between 2014 and 2035, to 26 cases per 100,000 people by 2035.[1] This includes a smaller decrease for males than for females.

For males, non-Hodgkin lymphoma European age-standardised (AS) incidence rates in the UK are projected to fall by 3% between 2014 and 2035, to 32 cases per 100,000 by 2035.[1] For females, rates are projected to fall by 3% between 2014 and 2035, to 22 cases per 100,000 by 2035.[1]

Non-Hodgkin lymphoma (C82-C85), Observed and Projected Age-Standardised Incidence Rates, by Sex, UK, 1979-2035

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It is projected that 18,621 cases of non-Hodgkin lymphoma (10,489 in males, 8,132 in females) will be diagnosed in the UK in 2035.

The lifetime risk of developing non-Hodgkin lymphoma (NHL) (all subtypes combined) is 1 in 48 for men and 1 in 58 for women, in 2012 in the UK.[1]

The lifetime risk for NHL has been calculated on the assumption that the possibility of having more than one diagnosis of NHL over the course of a lifetime is very low (‘Current Probability’ method).[2]

There is evidence for a small association between non-Hodgkin lymphoma (NHL) incidence and deprivation for females in England, but there is no evidence for an association for males.[1] England-wide data for 2006-2010 show European age-standardised incidence rates are 6% higher for females living in the most deprived areas compared with the least deprived, but for males the rates are similar for those living in the least and most deprived areas.[1]

Non-Hodgkin Lymphoma (C82-C85), European Age-Standardised Incidence Rates by Deprivation Quintile, England, 2006-2010

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For males diagnosed with non-Hodgkin lymphoma the deprivation gradient has gone from having higher incidence rates in the less deprived in 1996-2000 to having higher incidence rates in the more deprived in 2006-2010. The estimated deprivation gradient in non-Hodgkin lymphoma incidence between people living in the most and least deprived areas in England has not changed in the period 1996-2010.

It has been estimated that there would have been around 50 more cancer cases each year amongst males in England during 2006-2010 if all males experienced the same incidence rates as the least deprived.[1]

Age-standardised rates for White males with Non-Hodgkin lymphoma (ICD-10 C82-C85 and C96) range from 15.7 to 16.5 per 100,000. Rates for Asian males are similar, ranging from 10.3 to 16.9 per 100,000 and the rates for Black males are also similar, ranging from 11.4 to 19.6 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 11.2 to 11.8 per 100,000 and rates for Asian and Black females are also similar ranging from 7.0 to 11.8 per 100,000 and 8.7 to 15.1 per 100,000 respectively.[1]

There appears to be no significant variation in Non-Hodgkin lymphoma incidence by ethnicity in the UK.[1,2] However, US data shows that since 1992, NHL rates have been significantly higher in non-Hispanic white people than in black people.[3]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For Non-Hodgkin lymphoma, 42,576 cases were identified; 21% had no known ethnicity.

In the UK around 46,000 people were still alive at the end of 2006, up to ten years after being diagnosed with Non-Hodgkin lymphoma (all subtypes combined).[1]

Non-Hodgkin Lymphoma (C82-C85 and C96), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

Worldwide, it is estimated that there were around 772,000 men and women still alive in 2008, up to five years after their diagnosis.[2]

Non-Hodgkin lymphoma (NHL) (C82-C85 and C96) is the 11th most common cancer in Europe, with around 93,500 new cases diagnosed in 2012 (3% of the total). In Europe (2012), the highest World age-standardised incidence rates for NHL are in Italy for men and the Netherlands for women; the lowest rates are in Albania for both men and women. UK NHL incidence rates are estimated to the ninth highest in males in Europe, and eighth highest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

NHL (C82-C85 and C96) is the tenth most common cancer worldwide, with nearly 386,000 new cases diagnosed in 2012 (3% of the total). NHL incidence rates are highest in Northern America and lowest in South Central Asia, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.