Hodgkin lymphoma incidence statistics

Hodgkin lymphoma accounts for less than 1% of all cancers in the UK (2012).[1-4]

In 2012, there were 1,831 new cases of Hodgkin lymphoma in the UK: 1,041 (57%) in males and 790 (43%) in females, giving a male:female ratio of around 13:10.[1-4] The crude incidence rate Open a glossary item shows that there are 3 new Hodgkin lymphoma cases for every 100,000 males in the UK and 2 for every 100,000 females.

The European age-standardised incidence rates Open a glossary item (AS rates) in females is significantly lower in Wales compared to England. Rates do not differ significantly between the other constituent countries of the UK for either sex.[1-4]

Hodgkin Lymphoma (C81), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Male Cases 869 43 94 35 1,041
Crude Rate 3.3 2.8 3.6 3.9 3.3
AS Rate 3.4 2.9 3.7 4.3 3.4
AS Rate - 95% LCL 3.2 2.1 3.0 2.8 3.2
AS Rate - 95% UCL 3.7 3.8 4.5 5.7 3.7
Female Cases 686 25 60 19 790
Crude Rate 2.5 1.6 2.2 2.0 2.4
AS Rate 2.5 1.6 2.2 2.2 2.4
AS Rate - 95% LCL 2.3 1.0 1.6 1.2 2.3
AS Rate - 95% UCL 2.7 2.2 2.7 3.2 2.6
Persons Cases 1,555 68 154 54 1,831
Crude Rate 2.9 2.2 2.9 3.0 2.9
AS Rate 3.0 2.2 2.9 3.1 2.9
AS Rate - 95% LCL 2.8 1.7 2.5 2.3 2.8
AS Rate - 95% UCL 3.1 2.7 3.4 4.0 3.1

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

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 60% of all Hodgkin lymphoma cases diagnosed in the UK in 2010-2012, and nodular lymphocyte-predominant Hodgkin lymphoma (ICD-10 C81.0) which accounted for 10% of cases. The remaining 29% of Hodgkin lymphoma cases in the UK in 2010-2012 were of other or unspecified Hodgkin lymphoma types (ICD-10 C81.7, C81.9).[1-4]

Hodgkin Lymphoma Subtypes, Annual Average Number of New Cases, European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2010-2012

  Classical Hodgkin lymphoma Nodular lymphocyte-predominant Hodgkin lymphoma Other and unspecified Hodgkin lymphoma
Male Cases 606 142 310
AS Rate (95% LCL-95% UCL) 2.0 (1.9-2.1) 0.5 (0.4-0.5) 1.1 (1.0-1.1)
Female Cases 513 51 234
AS Rate (95% LCL-95% UCL) 1.6 (1.6-1.7) 0.2 (0.1-0.2) 0.7 (0.7-0.8)
Persons Cases 1119 194 543
AS Rate (95% LCL-95% UCL) 1.8 (1.7-1.8) 0.3 (0.3-0.3) 0.9 (0.9-0.9)

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. 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, April 2014. 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, April 2014. 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 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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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 2010 and 2012, an average of 10% of cases were diagnosed in men and women aged 75 years and over, and more than a fifth (22%) were diagnosed in children, teenagers and young adults aged 24 and under.[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 14:10 and 22:10.[1-4]

Hodgkin Lymphoma (C81), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. 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, April 2014. 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, April 2014. 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 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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Hodgkin lymphoma incidence rates have remained stable overall for males and increased overall for females in Great Britain since the late-1970s, though for both sexes this includes a decrease followed by an increase.[1-3] For males, European age-standardised Open a glossary item (AS) incidence rates decreased by 21% between 1979-1981 and 1995-1997, then increased by 26% between 1995-1997 and 2010-2012. For females, rates decreased by 16% between 1979-1981 and 1989-1991, then increased by 35% between 1989-1991 and 2010-2012.

Trends in Hodgkin lymphoma incidence probably largely reflect changes in diagnosis, classification and registration practices.[4-6]

Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Over the last decade in the UK (between 2001-2003 and 2010-2012), the European AS incidence rates have increased by 17% and 23% in males and females, respectively.[1-4]

Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Hodgkin lymphoma incidence rates have remained stable overall for most broad adult age groups in Great Britain since the late-1970s, though there has been a slight increase in younger adults.[1-3] In people aged 0-24, European AS incidence rates increased overall by 21% between 1979-1981 and 2010-2012, with most of this increase in the last decade. In the older age groups (25-49, 50-59, 60-69, 70-79, and 80+), rates decreased between the late-1970s and mid-1990s; and have since increased; the most pronounced changes have been in the 70-79 age group, where rates dropped by 44% between 1979-1981 and 1993-1995, then rose by 92% between 1993-1995 and 2007-2009, and have since remained stable.

Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates, by Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. 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, April 2014. 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, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. 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.
  5. 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.
  6. Roman E, Smith AG. Epidemiology of lymphomas. Histopathology 2011, 58:4–14.
  7. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
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Staging for Hodgkin lymphoma most commonly uses the Ann Arbor system.[1]

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.[2] In the meantime, incidence by stage is available for the former Anglia Cancer Network in the east of England for the period 2004-2008.[3] 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.[3] For around a sixth (17%) of patients, the stage is not known.

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

References

  1. Smithers DW. Summary of papers delivered at the Conference on Staging in Hodgkin's Disease (Ann Arbor). Cancer Res 1971; 31(11):1869-70.
  2. Department of Health. Improving outcomes: a strategy for cancer. London: Department of Health; 2011.
  3. Data were provided by The National Cancer Registration Service, Eastern Office on request.
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The lifetime risk of developing Hodgkin lymphoma is around 1 in 370 for men and around 1 in 490 for women, in 2012 in the UK.[1]

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

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Esteve J, Benhamou E and Raymond L. Descriptive epidemiology. IARC Scientific Publications No.128, Lyon, International Agency for Research on Cancer, pp 67-68 1994.
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Around 17,600 new cases of Hodgkin lymphoma were diagnosed in Europe in 2012 (0.5% of total cancer cases). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for Hodgkin lymphoma are in Croatia for both men and women; the lowest rates are in Iceland for men and Albania for women. UK Hodgkin lymphoma incidence rates are estimated to be the 6th highest in males in Europe, and 20th lowest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Around 66,000 new cases of Hodgkin lymphoma were diagnosed worldwide in 2012 (0.5% of total cancer cases). Hodgkin lymphoma incidence rates are highest in Northern America and lowest in Eastern 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.

References

  1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
  2. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
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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.[1-5]

References

  1. 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.
  2. Petridou E, Andrie E, Dessypris N, et al. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. 2009.
  3. Gutensohn NM, Shapiro DS. Social class risk factors among children with Hodgkin's Disease. International Journal of Cancer 1982; 30(4):433-5.
  4. 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.
  5. 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.
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Age-standardised Open a glossary item 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.[1] 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.

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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.[1]

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

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.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence (June 2010)
  2. 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
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