Ongoing Improvement in Outcomes for Patients Diagnosed as Having Non-Hodgkin Lymphoma From the 1990s to the Early 21st Century

Abstract

Non-Hodgkin lymphoma (NHL) is the most common hematologic malignant neoplasm in adults. We use the novel technique of period analysis to disclose the most recent trends in survival among adults diagnosed as having NHL on the population level with minimum delay. We estimated trends in 5- and 10-year relative survival in patients 15 years or older diagnosed as having NHL in the United States between 1990 and 2004 using data from the Surveillance, Epidemiology, and End Results (SEER) program. We also estimated survival by age, location and histologic type of the tumor, sex, and race to further elucidate trends in survival in this disease. Overall, 5-year relative survival increased from 50.4% to 66.8%, and 10-year relative survival increased from 39.4% to 56.3% between 1990-1992 and 2002-2004. Improvements were most pronounced in patients younger than 45 years (+26.8 and +27.1 percentage points for 5- and 10-year survival, respectively), but improvements were seen in all age groups, in both sexes, in both nodal and extranodal disease, and in both low-grade and high-grade disease. Improvements in prognosis were less in black patients than in white patients, especially in younger black patients. Our period analysis discloses a strongly improved outlook for patients diagnosed as having NHL in recent years. Changes in treatment of the disease and a decrease in the number of human immunodeficiency virus-related NHL cases attributable to highly active antiretroviral therapy are probably primarily responsible for these improvements.