Hodgkin lymphoma - UK incidence statistics

Hodgkin lymphoma accounts for about 0.6% of all cancers diagnosed in the UK, yet it is one of the most common cancers among older children and adolescents. Hodgkin lymphoma is also one of the most curable forms of cancer.

Hodgkin lymphoma is a type of cancer affecting the lymphatic system (Figure 1.1).3-6

Figure 1.1: The Lymphatic System Showing Sites Commonly Affected by Hodgkin Lymphoma

There were 1,730 new cases of Hodgkin lymphoma diagnosed in the UK in 2008. Table 1.13-6 shows the numbers and rates of new cases of Hodgkin lymphoma in the UK and its constituent countries.

Table 1.1: Hodgkin Lymphoma (C81), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2008

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Section Last updated: 26/08/2011

In the UK there are two peaks in the age-specific incidence of Hodgkin lymphoma. For males there is one in men aged 20-34 and another in older men aged 75-79 years. For women the two peaks occur in women aged 20-24 and 70-74 (Figure 1.2).3-6 In the UK incidence rates for Hodgkin lymphoma in males are higher at 3.0 per 100,000 compared with 2.4 per 100,000 females. Hodgkin lymphoma is the third most commonly diagnosed cancer in people aged 15-29 years, and the sixth most commonly diagnosed cancer in children under 15.

It has been estimated that the lifetime risk of developing Hodgkin lymphoma is approximately 1 in 440 for men and 1 in 500 for women in the UK. These were calculated in May 2011 using incidence and mortality data for 2006-2008 using the AMP method.7

Figure 1.2: Hodgkin Lymphoma (C81), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK, 2008

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Section last updated: 26/08/2011

There are several different pathologic types of Hodgkin lymphoma recognised. The commonest is Classical Hodgkin lymphoma which is further sub-divided into nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted types 8. Using data for 2006-2008, nodular sclerosing Hodgkin lymphoma accounts for around half of all newly diagnosed cases of the disease, and the mixed cellularity subtype accounts for around 13% of cases. The other types are described by the WHO classification. The Lymphocyte-rich type constitutes around 10% of cases and the lymphocyte-deplete type is uncommon. The other, much less common type of Hodgkin lymphoma is nodular lymphocyte-predominant Hodgkin lymphoma, which constitutes only 5% of all cases of the disease 8.

The incidence of Hodgkin lymphoma subtypes varies by age-group and socio-economic status. Mixed cellularity disease is more common, especially at younger ages, in poorer countries, while the incidence of nodular sclerosis is higher in more affluent populations.8 

In England, incidence rates for nodular sclerosis Hodgkin lymphoma peak in young adults aged 20-24. Female rates are higher in adolescence, young adulthood and early middle aged; this difference is reversed by age 40 after which male rates are generally higher (Figure 1.3).3

Figure 1.3: Nodular Sclerosing Hodgkin Lymphoma (C81.1) and Mixed Cellularity Subtypes of Hodgkin Lymphoma (C81.2), Crude Rates per 100,000, England, 2006-2008

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*The average number of new cases diagnosed per year are included in the download for this chart

The age-specific incidence rates of the mixed cellularity subtype of Hodgkin’s lymphoma increase to around 0.5-0.6 and 0.2-0.4 per 100,000 population in males and females respectively and remain stable between ages 20-64. Those aged 65 and over generally have slightly higher incidence than the younger age groups. Incidence is higher for men than for women in almost all age groups (Figure 1.3).3

Section Last updated: 26/08/2011

There are 4 stages of Hodgkin lymphoma as defined using the Ann Arbor staging.9

• Stage 1 - means there is Hodgkin lymphoma in only 1 group of lymph nodes or lymphoma in 1 body organ only
• Stage 2 - means Hodgkin lymphoma in 2 or more groups of lymph nodes or an organ and 1 or more group of lymph nodes. In both cases, the 2 sites of lymphoma must be on the same side of the diaphragm
• Stage 3 - means Hodgkin lymphoma in lymph nodes on both sides of the diaphragm
• Stage 4 - means that many groups of lymph nodes contain Hodgkin lymphoma and it has spread to body organs such as the liver, bones or lungs

Data from Eastern Cancer Registry and Information Centre (ECRIC) show that in the East of England over 50% of cases of Hodgkin Lymphoma are diagnosed at stage 1 or 2 with almost 18% diagnosed at stage 4 and over 12% of cases with stage not known (Table 1.2).10 The regional data from ECRIC are used here because, at present, good quality consistent staging data are unavailable nationally.

Table 1.2: Hodgkin Lymphoma (C81), Average Number of New Cases Diagnosed per  Year and the Percentage of New Cases Diagnosed by Stage at Diagnosis, East of England, 2004-2008

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section last updated 26/08/2011

Between the mid-1970s and the mid 1980's, the age-standardised incidence rates for Hodgkin lymphoma in males in Britain have decreased. Since then, however, they have remained largely unchanged at around 3 per 100,000 males. The incidence rates in women remained relatively stable at 2 per 100,000 females throughout (Figure 1.4).3-5

Figure 1.4: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, by Sex, Great Britain, 1975-2008

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At least part of the declining trend in the 1970s and 1980s may be attributed to changes in the classification of some types of Hodgkin lymphoma as non-Hodgkin lymphoma11 for which there have been increasing trends over the last two decades (see non-Hodgkin lymphoma section). These trends are also reflected in the age-specific rates for Hodgkin lymphoma.

The incidence trend for Hodgkin lymphoma in the UK, is shown in Figure 1.53-6.

Figure 1.5: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, by Sex, UK, 1993-2008

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Section last updated: 26/08/2011

There is wide international variation in the incidence of Hodgkin lymphoma, the variation is similar for males and females (Figure 1.6).12 The highest rates are in Southern Europe and Northern America. In many parts of Asia and Africa, incidence rates for Hodgkin lymphoma are 1 per 100,000 population, with the world average being around 1.2 per 100,000 for males and 0.8 per 100,000 for females. Note, World age-standardised rates cannot be compared directly with European age-standardised rates.

Figure 1.6: Hodgkin Lymphoma (C81), World Age-Standardised Incidence Rates per 100,000 Population, World Regions, 2008 Estimates

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There is some variation in the incidence of Hodgkin Lymphoma between the 27 countries of the European Union (EU) (Figure 1.7).13

Figure 1.7: Hodgkin Lymphoma (C81), European Age-Standardised Incidence Rates per 100,000 Population, EU-27 countries, 2008 Estimates

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Section last updated: 26/08/2011

Prevalence data relate to those people in the UK population who were alive on a specific date having previously been diagnosed with cancer. The latest analysis shows that on 31st December 2006, around 11,500 people were alive up to ten years after being diagnosed with Hodgkin lymphoma. Table 1.3 shows the one, five and ten year prevalence by sex for Hodgkin lymphoma.14

Table 1.3: Hodgkin Lymphoma (C81), One, Five and Ten year Prevalence, UK, 31st December 2006

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Section Last updated: June 2010