by sabada dube epidemiology: non-hodgkin’s lymphoma. increasing incidence over the past three...

By Sabada Dube

Epidemiology: Non-Hodgkin’s Lymphoma.

Increasing incidence over the past three decades but

drivers of increase still unknownCountry Coverage: the US, Japan, France, Germany, Italy, Spain, and the UK

© Datamonitor Healthcare. All rights reserved.2

Epidemiology: Non-Hodgkin’s Lymphoma

Key findings• Datamonitor Healthcare's key findings



Datamonitor Healthcare’s key findingsDisease overview

• Non-Hodgkin's lymphoma (NHL) is a cancer that originates in lymphocytes, which are blood cells that form part of the immune system. NHL comprises a highly heterogeneous group of malignancies, displaying distinct behavioral, prognostic, and epidemiologic characteristics.

• NHL is slightly more predominant in developed countries where some 51% of global NHL cases occur.

• In 2008, there were approximately 356,000 NHL diagnoses across the globe. Incidence rates and historical trends of NHL are similar in the US and European markets, whereas Asian countries are known for a historically lower incidence.

Incidence estimates

• In 2012, Datamonitor Healthcare estimates that 145,820 incident cases of NHL occurred in the US, Japan, and five major EU markets (France, Germany, Italy, Spain, and the UK).

• Of all the incident NHL cases in these markets, 71,300 (or 49%) were in the US, while approximately 58,610 occurred in the five major EU markets. The number of cases was similar across these markets and substantially lower than in the US – there were 10,780, 14,410, 15,440, 7,390, and 10,590 incident cases in France, Germany, Italy, Spain, and the UK, respectively.

NHL subtype

• More than half of NHL cases are diffuse large B-cell and follicular lymphoma.

Epidemiologic drivers

• Risk factors for NHL are well established. These are immunodeficiency, infectious diseases (human T-cell lymphotropic virus, Epstein-Barr virus, Helicobacter pylori), obesity, tobacco smoking, and poor nutrition.

• However, contemporary epidemiologic trends have only been directly influenced by the advent of HIV/AIDS and, potentially, the rise of obesity in the Western population.

• Consequently, the rise in diagnosis of NHL is mainly attributable to increased awareness and improvements in diagnostic procedures.



• Non-Hodgkin’s Lymphoma definition and ICD codes

Disease overview



Non-Hodgkin’s lymphoma definition

• NHL is a cancer that originates in lymphocytes, which are blood cells that form part of the immune system.

• NHL comprises a highly heterogeneous group of malignancies, displaying distinct behavioral, prognostic, and

epidemiologic characteristics. NHL is slightly more predominant in developed countries where some 51% of

global NHL cases occur.

• There are several subtypes of NHL, with marked variation between them.

• Incidence rates vary by age and sex. Survival rates, risk factors, and treatment also vary by subtype.

• Some NHL subtypes can be aggressive, developing quickly. Others can be indolent, developing slowly and often

not causing symptoms for many years.

• NHL classified in the International Classification of Diseases (ICD) as ICD code-9 200 and 202, and ICD code-10

C82–85 and C96 was included in this analysis.



Non-Hodgkin’s lymphoma forecast

• Epidemiologic forecast results



Increase in patient populations across markets

Non-Hodgkin’s lymphoma forecast

• In 2012, Datamonitor Healthcare estimates that 145,820 incident cases of NHL occurred in the US,

Japan, and five major EU markets. Of all the incident NHL cases in the US, Japan, and five major

EU markets, 71,300 (or 49%) were in the US.

• In the same year, approximately 58,610 incident NHL cases occurred in the five major EU markets.

There were 10,780, 14,410, 15,440, 7,390, and 10,590 incident cases in France, Germany, Italy,

Spain, and the UK, respectively.

• In Japan, there were 15,910 incident cases of NHL in 2012.

• Between 2012 and 2030, incident NHL cases will increase by 41% in the US, Japan, and five major

EU markets.

• The largest growth in incident cases over the forecast period will be in Italy (59%) followed by the

US (48%). In Spain, NHL incident cases will grow by 40%, while growth over the period will be 34%,

29%, 25%, and 16% in the UK, France, Japan, and Germany, respectively.

© Datamonitor Healthcare. All rights reserved.

NHL subtypes diagnosed in 2012

• Across these markets, approximately 85% of all NHL cases are B-cell lymphomas, with the majority being diffuse large B-cell

and follicular lymphomas.

More than half of incident cases are diffuse large B-cell and follicular lymphoma

Epidemiology: Non-Hodgkin’s Lymphoma8

US Japan France Germany Italy Spain UK

Diffuse large B-cell lymphoma 22,100 4,930 3,340 4,470 4,790 2,290 3,280

Follicular lymphoma 15,690 3,500 2,370 3,170 3,400 1,630 2,330

Mucosa-associated lymphatic tissue lymphoma 5,350 1,190 810 1,080 1,160 550 790

Small cell lymphocytic lymphoma/chronic lymphocytic leukemia 4,990 1,110 750 1,010 1,080 520 740

Mantle cell lymphoma 4,280 950 650 860 930 440 640

Mediastinal (thymic) large B-cell lymphoma 1,710 380 260 350 370 180 250

Lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia 1,430 320 220 290 310 150 210

Nodal marginal zone B-cell lymphoma 1,430 320 220 290 310 150 210

Splenic marginal zone lymphoma 710 160 110 140 150 70 110

Extranodal marginal zone B-cell lymphoma 710 160 110 140 150 70 110

Intravascular large B-cell lymphoma 710 160 110 140 150 70 110

Primary effusion lymphoma 710 160 110 140 150 70 110

Burkitt's lymphoma 1,780 400 270 360 390 180 260

Lymphomatoid granulomatosis 710 160 110 140 150 70 110

T-cell and natural killer cell lymphoma 8,560 1,910 1,290 1,730 1,850 890 1,270

Immunodeficiency-associated lymphoproliferative disorders 430 100 60 90 90 40 60

Total NHL incident cases 71,300 15,910 10,780 14,410 15,440 7,390 10,590



.Conclusions and key takeaways

© Datamonitor Healthcare. All rights reserved.

Conclusions

10

NHL incidence will continue to increase

• In the near future, NHL incidence will continue to increase across the US, Japan, and five major EU markets.

• The growth in incident cases is due to real increases in the diagnosis of NHL in these markets, as well as

background population aging. NHL incidence is highest in older age groups, and as the populations age NHL

diagnoses are also expected to rise.

• The increase in incident NHL cases projected in the US, Japan, and five major EU markets is in line with trends

observed in the majority of developed countries.

• In these markets, the increase in NHL incidence is attributable to several factors including improvements in

diagnostic techniques and data registration systems, such that the increase cannot be credited to any known

risk factors.

• However, HIV is the only risk factor that is known to have changed over time, leading to an increase in the

number of NHL cases among HIV-infected individuals.


DisclaimerAll Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher, Datamonitor Healthcare. The facts of this report are believed to be correct at the time of publication but cannot be guaranteed. Please note that the findings, conclusions and recommendations that Datamonitor Healthcare delivers will be based on information gathered in good faith from both primary and secondary sources, whose accuracy we are not always in a position to guarantee. As such Datamonitor Healthcare can accept no liability whatever for actions taken based on any information that may subsequently prove to be incorrect.

Datamonitor Healthcare is owned and operated by Informa plc (“Informa”) whose registered office is Mortimer House, 37-41 Mortimer Street, London, W1T 3JH. Registered in England and Wales Number 3099067.

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