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Hodgkin's and non-Hodgkin's lymphomas
P Hartge1, S S Devesa, J F Fraumeni
1Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, MD 20892.
Cancer Surveys
|January 1, 1994
Summary
Incidence of Hodgkin's disease (HD) is declining, while non-Hodgkin's lymphoma (NHL) rates are rising globally. Further research into environmental factors and viruses is crucial for understanding and preventing these lymphomas.
Area of Science:
- Hematology
- Epidemiology
- Oncology
Background:
- Hodgkin's disease (HD) incidence shows geographic variation and a recent slight decline, with subtype shifts observed.
- Non-Hodgkin's lymphoma (NHL) incidence and mortality have risen dramatically and universally over recent decades.
- While diagnostic improvements contribute, etiological factors are increasingly implicated in NHL trends.
Purpose of the Study:
- To analyze trends in Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) incidence and mortality.
- To explore potential causes for observed changes in lymphoma rates.
- To highlight the need for further epidemiological research into lymphoma origins.
Main Methods:
- Analysis of incidence and mortality data from population-based registries.
- Examination of trends by age group, subtype, and geographic region.
- Review of potential contributing factors including diagnostic improvements, viral infections, and environmental exposures.
Main Results:
- HD incidence is declining overall, with decreases in older populations but increases in young adults in some regions. Nodular sclerosis subtype is increasing while mixed cellularity declines.
- NHL incidence is rising 3-4% annually worldwide, with steeper increases in older age groups.
- HIV infections contribute to NHL rise, but do not explain the long-term trend; environmental factors and other viruses are suspected.
Conclusions:
- Therapeutic advances have reduced HD mortality, but understanding causal agents like EBV is key for prevention.
- The persistent global rise in NHL suggests significant etiological drivers beyond improved diagnostics.
- Further epidemiological research is essential to identify environmental, infectious, and lifestyle factors contributing to lymphoma development and to inform preventive strategies.