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Blood, 1 January 2006, Vol. 107, No. 1, pp. 265-276.
Prepublished online as a Blood First Edition Paper on September 8, 2005; DOI 10.1182/blood-2005-06-2508.


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Submitted June 24, 2005
Accepted August 26, 2005

Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001

Lindsay M Morton*, Sophia S Wang, Susan S Devesa, Patricia Hartge, Dennis D Weisenburger, and Martha S Linet

Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA

* Corresponding author; email: mortonli{at}mail.nih.gov.

Because the causes of most lymphoid neoplasms remain unknown, comparison of incidence patterns by disease subtype may provide critical clues for future etiologic investigations. We therefore conducted a comprehensive assessment of 114,548 lymphoid neoplasms diagnosed during 1992-2001 in 12 SEER registries according to the internationally-recognized WHO lymphoma classification introduced in 2001. Cases coded in ICD-O-2 were converted to ICD-O-3 for WHO subtype assignment. Age-specific and age-adjusted rates were compared by sex and race (white, black, Asian). Age-adjusted trends in incidence were estimated by sex and race using weighted least-squares log-linear regression. Diverse incidence patterns and trends were observed by lymphoid neoplasm subtype and population. In the elderly (75+ years), rates of DLBCL and follicular lymphoma increased 1.4% and 1.8% per year, respectively, whereas rates of CLL/SLL declined 2.1% per year. Although whites bear the highest incidence burden for most lymphoid neoplasm subtypes, most notably for hairy cell leukemia and follicular lymphoma, black predominance was observed for plasma cell and T-cell neoplasms. Asians have considerably lower rates than whites and blacks for CLL/SLL and Hodgkin lymphoma. We conclude that the striking differences in incidence patterns by histologic subtype strongly suggest that there is etiologic heterogeneity among lymphoid neoplasms, and support the pursuit of epidemiologic analysis by subtype.


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