Chapter 4: Cancer incidence in Canada: trends and projections (1983-2032) – Non-Hodgkin lymphoma - HPCDP: Volume 35, Supplement 1, Spring 2015

Chapter 4: Projections by Cancer Site

21. Non-Hodgkin lymphoma

In 2003–2007, non-Hodgkin lymphoma (NHL) was the fifth most common type of new cancer diagnosis in Canadian males and females, and the most common lymphohematopoietic cancer. The average annual number of newly diagnosed NHL cases in this period was 3455 for males and 2915 for females, representing 4.3% and 3.9% of all new male and female cancer cases, respectively (Tables 4.21.1 and 4.21.2).

TABLE 4.21.1
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), non-Hodgkin lymphoma, males, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 445 60 45 10 15 185 100 10 15 0 5 0
45–54 495 60 45 15 15 200 115 15 20 0 5 0
55–64 740 105 65 20 30 280 180 25 25 5 10 0
65–74 860 115 80 30 35 340 195 20 30 5 10 0
75–84 730 110 60 25 30 280 175 20 20 5 10 0
85+ 185 30 20 10 5 70 35 5 5 0 0 0
Total 3455 480 310 110 130 1355 800 95 110 15 45 5
2008–12 <45 400 55 45 10 10 165 90 10 10 0 5 0
45–54 530 65 50 20 20 210 120 15 20 0 10 0
55–64 880 120 80 25 30 345 195 25 30 5 15 0
65–74 1025 150 90 30 35 395 235 30 35 5 15 0
75–84 855 125 75 30 30 335 205 20 25 5 5 0
85+ 275 50 25 10 10 100 65 10 10 0 0 0
Total 3970 555 365 125 145 1550 915 105 130 20 50 10
2013–17 <45 395 60 40 10 10 165 85 10 10 0 5 0
45–54 490 55 50 15 15 200 105 15 20 0 10 0
55–64 955 130 95 30 30 370 210 30 35 5 15 5
65–74 1295 185 115 35 45 510 290 35 45 5 15 5
75–84 1005 145 85 30 40 390 240 25 30 5 10 0
85+ 375 60 35 15 15 145 90 10 10 0 0 0
Total 4515 630 420 140 155 1775 1025 120 145 20 55 10
2018–22 <45 400 65 40 15 10 165 85 10 10 0 5 0
45–54 410 40 45 15 15 170 90 10 15 0 10 0
55–64 995 130 95 35 35 400 210 25 35 5 15 5
65–74 1545 210 145 45 55 615 335 40 55 10 20 5
75–84 1245 185 110 35 45 470 300 30 35 5 10 0
85+ 470 70 45 15 15 180 110 10 15 0 0 0
Total 5060 700 475 155 170 2000 1140 130 165 25 60 10
2023–27 <45 410 70 40 15 10 170 90 10 10 0 5 0
45–54 380 45 35 15 15 155 85 10 10 0 5 0
55–64 930 110 95 30 35 385 190 25 35 5 15 0
65–74 1685 225 165 55 50 670 365 45 55 10 20 5
75–84 1605 230 140 40 55 615 380 35 50 10 15 5
85+ 580 90 50 15 20 220 140 15 15 0 0 0
Total 5590 765 525 175 185 2215 1250 140 180 25 65 10
2028–32 <45 405 70 40 15 10 175 85 10 10 0 5 0
45–54 385 50 40 20 10 150 85 10 10 0 5 0
55–64 795 85 80 30 30 330 165 25 25 5 15 0
65–74 1790 230 170 60 60 725 375 45 65 10 25 5
75–84 1940 265 180 55 65 750 450 45 60 10 15 5
85+ 735 115 70 20 20 275 180 20 20 5 5 0
Total 6050 820 570 195 200 2405 1345 150 195 30 70 15
TABLE 4.21.2
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), non-Hodgkin lymphoma, females, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 290 35 30 10 10 125 60 5 10 0 5 0
45–54 355 45 30 10 15 140 80 15 10 5 5 0
55–64 595 70 50 15 20 235 145 20 20 5 10 0
65–74 680 85 55 20 25 270 175 15 20 5 10 0
75–84 715 100 55 25 30 270 170 20 25 5 10 0
85+ 275 35 25 10 20 100 75 10 10 0 0 0
Total 2915 375 245 95 115 1145 705 75 95 15 40 5
2008–12 <45 300 35 30 10 10 130 60 5 10 0 5 0
45–54 420 50 40 15 15 165 95 15 15 0 10 0
55–64 685 85 60 20 25 270 165 20 25 5 15 0
65–74 795 110 65 20 25 310 195 20 25 5 15 0
75–84 775 100 65 25 30 300 190 20 20 5 10 0
85+ 350 50 30 15 15 130 85 10 10 0 0 0
Total 3330 430 295 100 120 1300 790 90 110 15 50 5
2013–17 <45 300 35 35 10 10 135 65 5 10 0 5 0
45–54 425 50 40 15 15 170 90 10 15 0 10 0
55–64 785 100 70 20 25 305 185 25 30 5 15 0
65–74 985 135 85 25 30 380 235 25 30 5 15 0
75–84 855 110 75 25 25 330 210 20 25 5 10 0
85+ 430 60 45 15 20 160 105 10 10 0 0 0
Total 3780 490 350 110 130 1475 880 95 120 15 55 5
2018–22 <45 300 40 35 10 10 135 60 5 10 0 5 0
45–54 420 45 40 10 20 165 85 10 15 0 10 0
55–64 870 110 80 25 25 340 195 25 30 5 15 0
65–74 1160 160 110 30 35 450 265 30 40 5 20 5
75–84 1005 140 90 25 30 380 240 25 30 5 10 0
85+ 505 65 55 15 20 190 125 10 10 0 0 0
Total 4255 555 410 115 140 1660 975 110 135 20 65 10
2023–27 <45 300 40 40 10 15 140 65 5 10 0 5 0
45–54 415 45 40 10 20 165 85 10 15 0 10 0
55–64 865 110 85 20 30 345 180 25 30 5 15 0
65–74 1320 185 125 30 40 505 300 30 45 5 25 5
75–84 1250 170 110 30 35 480 290 35 40 5 15 0
85+ 565 80 60 15 20 210 140 10 15 0 5 0
Total 4720 630 465 120 155 1840 1060 120 145 20 70 10
2028–32 <45 295 45 40 10 15 140 65 5 10 0 5 0
45–54 420 50 45 15 20 165 85 10 15 0 10 0
55–64 850 105 80 20 35 335 175 20 25 5 15 0
65–74 1455 205 140 35 40 565 315 35 45 5 25 5
75–84 1475 205 145 30 40 565 335 40 45 5 20 5
85+ 685 95 70 15 25 255 165 15 15 5 5 0
Total 5180 700 520 125 175 2025 1135 130 160 25 70 10

The lifetime risk for developing NHL is 2.4% in males and 1.9% in females.Endnote 1 NHL was the second most common (9.4%) incident cancer in males younger than 45 in 2003–2007 (Figure 3.9). The ASIRs of NHL increased with age to 122.0 per 100 000 in men aged 85 and over and to a maximum of 81.7 per 100 000 in women aged 75 to 84; the increase was less pronounced in women than in men (Tables 4.21.3 and 4.21.4).

TABLE 4.21.3
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), non-Hodgkin lymphoma, males, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 4.3 4.5 3.8 3.9 4.1 4.5 4.1 4.7 4.3 4.2 3.7 2.2
45–54 20.0 18.6 18.1 20.3 16.9 21.4 19.1 22.9 25.8 13.6 16.9 13.0
55–64 43.2 44.6 41.9 40.9 49.1 44.4 40.7 51.4 44.0 66.9 29.4 25.6
65–74 80.0 77.5 85.6 82.7 91.5 83.8 72.8 80.0 81.3 89.2 54.3 101.6
75–84 117.8 121.1 117.9 116.5 123.3 116.8 119.3 122.0 114.1 95.7 89.7 122.7
85+ 122.0 124.0 140.7 135.8 100.2 122.8 117.4 160.3 104.4 79.7 53.6 0.0
Total 19.7 19.8 19.7 19.6 20.6 20.4 18.9 21.6 20.2 20.5 14.4 16.4
2008–12 <45 4.0 4.1 3.6 4.0 3.2 4.3 4.0 4.6 4.1 4.2 3.9 4.2
45–54 19.3 17.6 17.7 23.8 19.3 19.8 18.3 22.9 26.4 20.2 21.2 18.4
55–64 42.8 42.0 41.0 42.1 45.9 45.3 38.8 47.2 48.4 44.8 34.5 37.5
65–74 82.9 84.1 85.0 79.0 89.4 85.8 75.5 95.7 84.7 86.8 56.4 78.7
75–84 122.8 120.8 128.4 125.7 131.4 123.7 122.4 110.2 120.0 128.6 62.9 119.7
85+ 131.8 146.8 133.7 128.6 132.0 122.9 139.4 153.1 118.9 138.0 48.9 126.1
Total 19.9 19.9 19.7 20.1 20.4 20.5 19.0 21.8 21.1 20.9 14.5 19.0
2013–17 <45 3.8 4.3 3.2 4.1 3.1 4.1 3.8 4.7 4.1 4.0 4.0 4.1
45–54 17.9 14.2 17.8 23.1 18.4 18.3 17.2 22.5 25.3 18.8 22.1 18.2
55–64 40.5 39.7 38.3 44.2 37.1 42.1 37.3 50.5 46.8 42.4 35.9 37.4
65–74 83.0 82.0 83.6 78.9 87.1 87.2 74.8 86.8 91.3 87.0 58.5 78.2
75–84 130.7 130.1 132.8 129.4 151.4 131.5 128.5 125.8 120.1 136.9 65.2 118.5
85+ 140.1 140.5 150.4 145.5 133.7 134.8 148.2 125.3 137.5 146.7 50.8 124.9
Total 19.9 19.6 19.4 20.6 20.1 20.5 18.9 21.8 21.5 20.8 15.1 18.9
2018–22 <45 3.7 4.5 3.1 4.1 2.7 3.9 3.6 4.8 4.1 3.9 4.0 4.1
45–54 16.3 11.7 15.0 24.6 17.5 16.6 16.4 23.2 20.5 17.0 22.8 18.0
55–64 38.3 36.4 34.7 45.0 38.5 39.5 34.9 46.8 47.5 40.1 36.9 37.0
65–74 81.5 77.1 81.1 81.6 83.6 86.4 73.6 81.5 91.9 85.4 60.0 77.7
75–84 134.1 135.7 134.0 124.5 143.7 133.8 131.6 137.5 126.3 140.4 66.8 118.2
85+ 148.4 144.6 159.1 159.9 139.7 143.9 154.1 130.5 156.9 155.4 52.1 123.8
Total 19.5 19.1 18.7 21.0 19.4 20.1 18.6 21.7 21.6 20.4 15.4 18.8
2023–27 <45 3.7 4.5 2.9 4.1 2.8 3.9 3.7 4.9 4.2 3.8 4.1 4.0
45–54 15.0 12.2 12.4 25.7 15.5 15.4 14.7 23.6 20.1 15.7 23.2 17.5
55–64 35.8 30.2 34.1 43.8 38.1 36.8 33.0 44.5 46.1 37.5 37.4 36.0
65–74 77.1 72.0 74.2 85.3 70.1 80.4 71.0 83.4 87.0 80.7 60.7 75.6
75–84 133.4 129.5 128.6 125.8 143.9 135.4 130.6 119.2 133.8 139.7 67.6 114.8
85+ 156.8 156.5 158.0 157.6 170.3 151.0 162.6 151.5 140.6 164.2 52.7 120.3
Total 18.9 18.2 17.6 21.3 18.5 19.4 18.1 21.2 21.2 19.8 15.6 18.2
2028–32 <45 3.6 4.5 2.8 4.1 2.8 3.9 3.5 4.9 4.2 3.7 4.1 3.9
45–54 14.4 13.1 12.0 25.7 12.9 14.3 14.6 24.0 20.2 15.1 23.5 17.0
55–64 32.6 24.8 29.4 46.3 35.3 33.5 31.7 45.2 37.6 34.1 37.9 35.0
65–74 73.3 66.1 68.1 86.1 73.2 76.0 67.0 76.7 90.5 76.8 61.4 72.9
75–84 130.5 122.0 124.8 129.0 134.3 133.1 128.8 115.1 134.0 136.7 68.4 111.2
85+ 156.6 157.8 158.6 149.3 134.0 149.5 163.0 156.6 164.3 164.0 53.4 116.6
Total 18.1 17.2 16.5 21.6 17.5 18.6 17.6 20.8 21.0 19.0 15.8 17.7
TABLE 4.21.4
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), non-Hodgkin lymphoma, females, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 2.9 2.7 2.6 3.6 2.6 3.2 2.5 2.9 3.3 2.5 2.8 2.7
45–54 14.2 13.2 12.9 13.6 16.7 14.7 13.3 21.4 15.8 23.6 15.0 2.9
55–64 33.7 30.1 32.4 31.3 33.4 35.9 32.1 40.2 38.7 31.8 33.1 13.3
65–74 57.2 55.0 57.8 55.7 55.6 58.7 57.3 45.4 58.5 58.2 53.0 67.0
75–84 81.7 86.0 79.8 86.0 92.4 80.6 79.4 80.9 84.9 98.8 66.6 151.6
85+ 80.9 69.1 87.5 74.0 111.0 79.5 89.7 81.7 70.2 21.4 23.5 0.0
Total 14.1 13.4 13.7 14.3 14.7 14.6 13.6 14.6 15.0 14.7 12.6 13.3
2008–12 <45 3.0 2.6 2.7 3.1 3.5 3.3 2.8 3.4 3.5 3.0 2.2 2.7
45–54 15.4 13.5 14.3 17.9 15.2 15.5 14.6 20.3 20.8 16.7 22.3 15.3
55–64 32.1 29.1 30.9 29.8 31.6 33.7 30.9 38.0 38.9 32.4 34.6 29.6
65–74 58.8 59.2 58.9 56.3 58.0 59.7 56.3 53.9 57.5 54.4 55.0 56.9
75–84 85.2 82.2 90.4 87.6 84.4 85.5 82.0 90.9 81.6 81.7 58.3 86.1
85+ 80.9 84.9 92.5 77.3 92.6 79.6 79.2 78.3 71.7 72.7 30.5 66.4
Total 14.4 13.6 14.3 14.4 14.7 14.8 13.8 15.6 15.6 14.0 13.1 13.7
2013–17 <45 3.0 2.6 2.8 3.3 3.4 3.3 2.8 3.5 3.5 3.0 2.2 2.8
45–54 15.9 13.5 15.3 17.5 17.3 15.5 14.8 20.7 21.1 16.9 23.1 15.5
55–64 32.2 29.7 30.3 28.9 32.3 32.8 31.5 38.5 39.4 32.8 35.9 30.3
65–74 58.4 56.9 58.0 57.0 54.4 59.8 54.7 54.7 58.3 54.8 56.8 58.0
75–84 88.5 86.0 94.3 85.6 81.5 87.9 85.6 92.1 82.6 82.2 60.2 87.7
85+ 84.4 83.2 103.1 84.5 97.4 82.0 81.6 79.4 72.6 73.3 31.6 67.3
Total 14.5 13.6 14.6 14.4 14.6 14.8 13.9 15.8 15.8 14.1 13.5 14.0
2018–22 <45 2.8 2.6 2.9 3.4 3.3 3.2 2.7 3.5 3.5 3.0 2.2 2.8
45–54 16.7 13.0 15.3 17.2 21.1 16.0 16.1 20.9 21.3 16.9 23.7 15.7
55–64 32.9 30.2 30.3 32.7 31.1 32.9 31.5 38.9 39.8 32.8 36.7 30.3
65–74 56.6 54.6 58.1 50.1 50.4 57.9 53.6 55.2 58.8 55.1 58.0 58.5
75–84 89.2 89.2 91.5 77.7 83.1 88.6 84.3 92.9 83.3 82.7 61.5 88.7
85+ 89.7 82.7 110.3 86.5 89.0 88.0 88.1 80.1 73.2 73.2 32.4 67.9
Total 14.5 13.6 14.6 14.1 14.6 14.8 13.9 15.9 15.9 14.2 13.7 14.1
2023–27 <45 2.7 2.7 3.1 3.4 3.3 3.1 2.7 3.6 3.5 3.0 2.2 2.8
45–54 16.4 12.2 14.1 17.5 20.7 16.1 15.6 21.0 21.4 16.9 24.0 15.5
55–64 33.2 30.0 31.6 30.7 34.4 32.6 31.4 39.1 40.0 32.8 37.2 30.2
65–74 56.5 55.3 55.9 48.6 52.4 56.4 54.5 55.4 59.0 54.8 58.7 58.2
75–84 87.6 84.8 89.0 76.5 78.3 87.8 81.9 93.3 83.7 82.5 62.1 87.7
85+ 90.7 88.9 110.1 78.0 90.5 87.3 89.3 80.4 73.5 73.5 32.8 67.3
Total 14.4 13.5 14.5 13.7 14.8 14.6 13.8 16.0 16.0 14.2 13.9 14.0
2028–32 <45 2.6 2.7 3.1 3.5 3.3 3.0 2.7 3.6 3.6 3.0 2.2 2.7
45–54 15.4 12.4 14.6 17.9 20.6 15.3 14.6 21.1 21.6 16.8 24.4 15.4
55–64 34.6 29.0 31.3 29.8 41.8 33.4 33.8 39.3 40.2 32.5 37.6 29.9
65–74 57.1 55.9 55.8 52.6 49.8 56.3 53.9 55.7 59.3 54.6 59.3 57.6
75–84 84.7 82.1 88.3 65.8 73.7 84.8 80.1 93.7 84.0 81.8 62.8 87.5
85+ 90.4 89.7 102.9 68.9 93.1 88.3 85.9 80.8 73.8 72.6 33.2 66.9
Total 14.3 13.4 14.4 13.5 15.1 14.4 13.8 16.1 16.0 14.1 14.0 13.9

Overall, NHL occurred nearly 1.5 times as often in males as in females. More than 70% of all incident NHL cases occurred in people aged 55 or older (Tables 4.21.1 and 4.20.2). NHL has an intermediate 5-year relative survival rate among all cancers in Canada, at 65% in males and 69% in females for 2006–2008.Endnote 1

Figure 4.21.1 indicates that overall incidence rates increased modestly in both sexes during the entire observation period. During 1998–2007, the ASIRs for NHL increased significantly in males by 0.8% per year and increased non-significantly in females by 0.5% (Figures 3.1 and 3.2).

FIGURE 4.21.1
Age-standardized incidence rates (ASIRs) by region, non-Hodgkin lymphoma, 1983–2032

Age-standardized incidence rates (ASIRs) by region, non-Hodgkin lymphoma, 1983–2032

[Click to enlarge]

[FIGURE 4.21.1, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.21.1
Age-standardized incidence rates (ASIRs) by region, non-Hodgkin lymphoma, 1983-2032

Figure 4.21.1 indicates that overall incidence rates of non-Hodgkin lymphoma (NHL) increased modestly in both sexes during the entire observation period. The incidence rates of NHL in males are predicted to peak in 2008-2012 and then decrease slightly, while the rates in females will peak in 2013-2017 and then level off. The projected flat trajectory of the rates might be because of a decrease in rates in later birth cohorts, especially in males. Even though the rates were very similar for all regions in the most recent 2 to 3 observed periods, the rates in the Atlantic region are predicted to diverge slightly in the future in females. The Atlantic region had the most marked increase, and these rates are projected to stabilize. The rates in the other regions are expected to be consistent, changing marginally with the same pattern as for the country.

Figure 4.21.2 reveals that the incidence of NHL increased over the observation periods for age groups above 55 in both sexes. For age groups below 55, the rates increased to their peaks in 1993–1997 for men under 45 and women aged 45 to 54, and in 1998–2002 for the opposite age–sex combinations, and then rates decreased.

FIGURE 4.21.2
Age-standardized incidence rates (ASIRs) for non-Hodgkin lymphoma by age group, Canada, 1983–2032 (red lines denote males, blue lines denote females)

Age-standardized incidence rates (ASIRs) for non-Hodgkin lymphoma by age group (males, females), Canada, 1983–2032

[Click to enlarge]

[FIGURE 4.21.2, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.21.2
Age-standardized incidence rates (ASIRs) for non-Hodgkin lymphoma by age group, Canada, 1983-2032

Figure 4.21.2 reveals that the incidence of non-Hodgkin lymphoma increased over the observation periods for the 55-or-older age groups in both sexes. For age groups below 55, the rates increased to their peaks in 1993-1997 for males under 45 and females aged 45 to 54, and in 1998-2002 for the opposite age-sex combinations, and then rates decreased. The ASIRs in males and females are projected to converge in age groups under 75 and to diverge in older age groups.

The incidence rates of NHL in males are predicted to peak (at 19.9 per 100 000) in 2008–2012 and then decrease slightly, while the rates in females will peak in 2013–2017 and then level off (Figure 4.21.1). The projected flat trajectory of the rates might be because of a decrease in rates in later birth cohorts, especially in males.

Even though the rates were very similar for all regions in the most recent 2 to 3 observed periods, the rates in the Atlantic region are predicted to diverge slightly in the future in females. The Atlantic region had the most marked increase, and these rates are projected to stabilize. The rates in the other regions are expected to be consistent, changing marginally with the same pattern as for the country.

Figure 4.21.2 shows that the ASIRs in males and females are projected to converge in age groups under 75 and to diverge in older age groups.

From 2003–2007 to 2028–2032, the ASIRs for NHL in Canada are projected to decrease by 8% in males, from 19.7 to 18.1 per 100 000, and to remain relatively stable in females, from 14.1 to 14.3 per 100 000 (Tables 4.21.3 and 4.21.4). The annual number of new male cases is estimated to increase by 75%, from 3455 to 6050, and the annual number of new female cases, by 78%, from 2915 to 5180 (Tables 4.21.1 and 4.21.2).

Comments

The observed incidence patterns likely result from a combination of improved detection and classification of this complex set of diseases, as well as changes in suspected risk factors because most of the risks for NHL are unknown.Endnote 36 Familial aggregations of NHL have been observed.Endnote 276, Endnote 277 Immunodeficiency is one of the best characterized and strongest known risk factors for NHL. Risk is increased whether the immunodeficiency is congenital, iatrogenic or acquired.Endnote 278 NHL is over 50 times more common in patients with congenital or acquired immunodeficiency than in the general population.Endnote 278 The increase in the prevalence of acquired immunodeficiency syndrome (AIDS) in the 1980s is responsible in part for increased incidence rates during that period.

Infectious agents of human T-cell lymphotropic virus type 1 (HTLV-1), EBV and HCV have also been associated with an increased risk of NHL.Endnote 47 A number of studies have pointed to a positive association between HCV infection and NHL,Endnote 279, Endnote 280 but a causal relationship is inconclusive.Endnote 281 A meta-analysis of 23 epidemiological studies presented a pooled odds ratio of 5.7 (95% CI: 4.1–8.0).Endnote 279 A more recent systematic review which included only studies with ≥100 cases reported a pooled relative risk of 2.5 (95% CI = 2.1–3.0), with consistent risks for B- and T-cell subtypes.Endnote 280

The projected increases of the Atlantic region's rates in females were based on the long-term steeply rising trends starting with much lower levels in earlier periods and are therefore less likely to continue and result in rates higher than for all other regions. Incidence data from the early 1990s should be accurate.Endnote 282

The causes of NHL are still largely unknown. Recent analyses describe the biological and clinical heterogeneity within the NHLs according to histology, suggesting that future epidemiological investigations need to focus on NHL risks and causal factors according to subtype.Endnote 283

Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: