Non-Hodgkin lymphoma - UK incidence statistics

This page presents the latest incidence statistics on non-Hodgkin lymphoma (NHL) by age and sex. Trends over time, geographic variation and prevalence data are also presented. Statistics on lymphomas in children are presented in the childhood cancer section. The ICD codes for non-Hodgkin lymphoma are ICD-10 C82-85, and C96.

A reliable classification system for haemotological malignancies, including the different sub-types of NHL, was developed and agreed by oncologists and pathologists in 20011 and this was updated in 2008.2 This is the World Health Organisation (WHO) classification. There are many sub-types of non-Hodgkin lymphoma, but they can all be put into one of two broad categories: high-grade non-Hodgkin lymphoma, where the cancer develops quickly and aggressively; and low-grade or indolent non-Hodgkin lymphoma, where the cancer develops slowly and there may be no symptoms for many years.

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By age and sex

In 2008 there were 11,861 people diagnosed with non-Hodgkin lymphoma in the UK (Table 1.1). 3-6  Of these, 11,755 (99%) were in adults aged 15 and over.

Table 1.1: Non-Hodgkin lymphoma (C82-C85 and C96), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2008

England Wales Scotland Northern Ireland United Kingdom
Male Cases 5,328 353 493 169 6,343
Crude Rate 21.0 24.2 19.7 19.4 21.0
AS Rate 17.7 18.8 16.4 18.7 17.7
AS Rate - 95% LCL* 17.2 16.8 14.9 15.8 17.2
AS Rate - 95% UCL* 18.2 20.8 17.8 21.5 18.1
Female Cases 4,648 293 440 137 5,518
Crude Rate 17.8 19.1 16.5 15.2 17.7
AS Rate 12.9 13.3 12.1 12.1 12.8
AS Rate - 95% LCL* 12.5 11.7 11.0 10.1 12.5
AS Rate - 95% UCL* 13.3 14.8 13.2 14.2 13.2
Persons Cases 9,976 646 933 306 11,861
Crude Rate 19.4 21.6 18.1 17.2 19.3
AS Rate 15.1 15.8 14.0 15.2 15.1
AS Rate - 95% LCL* 14.8 14.6 13.1 13.5 14.8
AS Rate - 95% UCL* 15.4 17.0 14.9 16.9 15.4

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

Non-Hodgkin lymphoma is the 5th most common cancer in the UK - it is the 5th most common cancer in males and the 7th in females. More men are diagnosed with non-Hodgkin lymphoma than women at a ratio of 1.15:1. However, because there are more older women than men in the population, the male age-standardised incidence rate is higher at 17.7 per 100,000 population than the female rate (12.8), a ratio of 1.4:1. 3-6 It has been estimated that the lifetime risk of developing NHL in 2008 is around 1 in 50 for men and 1 in around 60 for women in the UK. This was done using the AMP method.7

The incidence of NHL increases with age, with rates rising steadily from the age of 20, but with the increase rising more sharply in people over 50. More than two thirds (68%) of all male NHL cases, and nearly three quarters of all female NHL cases (74%) are diagnosed in those aged over 60 years (Figure 1.1). 3-6

 

Figure 1.1: Non-Hodgkin lymphoma (C82-C85 and C96), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

cases_crude_nhl1.swf

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Section updated: 07/09/11

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Trends over time

The incidence trends for non-Hodgkin lymphoma in Great Britain are shown in Figure 1.2. In 2006-2008, the age-standardised incidence rates for NHL were more than two and a half times what they were in 1975-77. 3-5

Figure 1.2: Non-Hodgkin lymphoma (C82-C85 and C96), European Age-Standardised Incidence Rates, Great Britain, 1975-2008

inc_asr_gb_nhl.swf

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The incidence trends for non-Hodgkin lymphoma in the UK are shown in Figure 1.3.

Figure 1.3: Non-Hodgkin lymphoma (C82-C85 and C96), European Age-Standardised Incidence Rates, UK, 1993-2008

inc_asr_uk_nhl.swf

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This pattern of increase has also been seen in the US 8 and Western Europe 9. There have also been increases in India, Japan, Brazil and Singapore. 10-11 In Britain the biggest increases in incidence have been in older people. Rates in those over 75 are more than three times higher than they were in 1975-77 (Figure 1.4). 3-5

 

Figure 1.4: Non-Hodgkin lymphoma (C82-C85 and C96), European Age-Standardised Incidence Rates, by Age, Great Britain, 1975-2008

inc_asr_age_p_nhl.swf

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These trends need to be interpreted with caution as at least some of the increase in incidence can be explained by changes in the diagnosis, classification and patient registration rates for NHL. 10, 12 However there is evidence to suggest that increases in incidence are real. 13, 14

Section updated: 07/09/11

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In the EU and worldwide

While there are no significant variations in the incidence of NHL across the UK, there are significant international variations in the incidence of NHL, with the highest rates in Northern America, Australia, New Zealand and Northern Europe and the lowest rates in Eastern and South Central Asia (Figure 1.5). It is estimated that worldwide there were around 356,000 new cases of non-Hodgkin lymphoma in 2008. 15

Figure 1.5: Non-Hodgkin lymphoma (C82-C85 and C96), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

world_inc_nhl.swf

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It is estimated that in the European Union there were around 74,000 new cases of non-Hodgkin lymphoma in 2008. Within the European Union (EU-27), the countries with the highest male incidence rates are Luxembourg and Finland, and the countries with the lowest are Bulgaria and Greece (Figure 1.6). 15 In females, the highest rates are found in Ireland, Luxembourg and Finland, and the lowest in Poland and Greece.

Figure 1.6: Non-Hodgkin lymphoma (C82-C85 and C96), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates

EU27_inc_nhl.swf

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Section updated: 07/09/11

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Prevalence

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 45,700 people were alive up to ten years after being diagnosed with non-Hodgkin lymphoma16. Table 1.3 shows the one, five and ten year prevalence by sex for non-Hodgkin lymphoma.

table showing non-Hodgkin lymphoma prevalence in the UK

Section updated: 07/09/11

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References for non-Hodgkin lymphoma incidence

  1.  Jaffe, E.S., et al., Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. World Health Organisation Classification of Tumours. 2001, Lyon, France: IARC Press.
  2.  Swerdlow SH, Campo E, Harris NL, et al., editors. World Health Organisation classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008.
  3.  Office for National Statistics. Cancer Statistics registrations: Registrations of cancer diagnosed in 2008, England. Series MB1 no.38. 2010
  4.  Welsh Cancer Intelligence and Surveillance Unit. Cancer registrations in Wales. 2010
  5.  ISD Online.Cancer Incidence, Mortality and Survival 2010
  6.  Northern Ireland Cancer Registry. Cancer Registrations in Northern Ireland, 2008 2010
  7.  Sasieni PD, Shelton J, Ormiston-Smith N, Thomson CS, Silcocks PB  What is the lifetime risk of developing cancer?: the effect of adjusting for multiple primaries. Br J Cancer, 2011. 105(3): p. 460-5.
  8.  National Cancer Institute. Non-Hodgkin's lymphoma incidence trends. 2004
  9.  Cartwright, R., et al., The rise in incidence of lymphomas in Europe 1985-1992. Eur J Cancer, 1999. 35(4): p. 627-33.
  10.  Devesa, S.S. and T. Fears, Non-Hodgkin's lymphoma time trends: United States and international data. Cancer Res, 1992. 52(19 Suppl): p. 5432s-5440s.
  11.  Naresh, K.N., V. Srinivas, and C.S. Soman, Distribution of various subtypes of non-Hodgkin's lymphoma in India: a study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol, 2000. 11 Suppl 1: p. 63-7.
  12.  Cartwright, R.A., Changes in the descriptive epidemiology of non-Hodgkin's lymphoma in Great Britain? Cancer Res, 1992. 52(19 Suppl): p. 5441s-5442s.
  13.  Banks, PM Changes in diagnosis of non-Hodgkin's lymphomas over time. Cancer Res 1992:52 (19 Suppl): 5453s-5s.
  14.  Hartge, P. and S.S. Devesa, Quantification of the impact of known risk factors on time trends in non-Hodgkin's lymphoma incidence. Cancer Res, 1992. 52(19 Suppl): p. 5566s-5569s.
  15.  Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. 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 .
  16. National Cancer Intelligence Network (NCIN) One,Five and Ten Year Cancer Prevalence (June 2010) .