Non-Hodgkin's Lymphoma

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Questions to Ask Your Doctor about Non-Hodgkin’s Lymphoma
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Non-Hodgkin's Lymphoma vs. Hodgkin's Disease

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Lymphomas are divided into two general categories—Hodgkin's disease (HD; also called Hodgkin's lymphoma), and non-Hodgkin's lymphoma (NHL). In the United States, there has been a general decline in HD rates over the past 20 years, so that this disease now accounts for only 1% of all cancers. By contrast, non-Hodgkin's lymphoma has increased by more than 70% during this period. It now represents 4% of all cancers and is the fifth most common malignancy in the United States.

According to the National Cancer Institute, there were approximately 66,120 new cases of NHL diagnosed in the United States in 2008 and about 19,000 people died from the disease.

The majority of NHLs (95%) occur in adults 40 to 70 years of age; however, some NHL subtypes are among the most common cancers in children. More men than women develop NHL, and rates are particularly high among men who live in locations of epidemic human immunodeficiency virus (HIV) infection, such as the San Francisco/Oakland area. Non-Hodgkin's lymphoma is more common in Caucasians than in African Americans or Asians.

In 2008, approximately 8,200 new cases of Hodgkin's disease were diagnosed in the United States. Among these cases, about 60% of cases involved advanced stage disease and 40% involved early-stage disease. Men typically have higher HD rates than women. This difference is particularly noticeable in children and among people older than 35 years of age. HD is more common in Caucasians than in African Americans or Asians. HD affects both adults and children, although it is most common in two age groups: young adults (aged 15–40) and older adults (age 55+). This age spread is more apparent in women, and may be related to hormonal factors. Only about 10–15% of HD cases occur in children who are younger than 16 years of age. The disease is uncommon in children age five and under.

Table 1: Facts & Figures For HD versus NHL, 1987- 1991

	Hodgkin's Disease	Non-Hodgkin's Lymphoma
Number of cases	3,540	17,568
Age-adjusted incidence* in 1991	2.9 cases per100,000 person-years	15.1 cases per100,000 person-years
Age at diagnosis (median)	33 years	65 years
Disease distribution by age: < 20 yrs 20-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65-74 yrs 75-84 yrs > 84 yrs	12.7 % 40.3 % 16.1 % 8.2 % 7.4 % 8.3 % 5.4 % 1.5 %	1.8 % 7.1 % 10.4 % 11.7 % 17.9 % 25.7 % 19.4 % 6.0 %

¥ - Based upon findings from the National Cancer Institute's SEER (Surveillance, Epidemiology, and End Results) program, 1987 to 1991.

* - Number of new cases occurring within a population of 100,000 individuals (corrected for age)
(Adapted from: Canellos G. P., Lister T. A., and Sklar J. L.: The Lymphomas. Philadelphia: W. B. Saunders Company, 1998).

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