Epidemiology of non-Hodgkin lymphoma in Connecticut. 1935-1988.

BACKGROUND: During the past decades, there have been reports of increases in the incidence and mortality rates due to non-Hodgkin lymphoma (NHL) in many parts of the world. The risk factors responsible for the increasing incidence are largely unknown. This study provided an overview of the incidence pattern of NHL in Connecticut and generated hypotheses for additional investigation.

METHODS: This study was based on all the NHL cases reported to the Connecticut Tumor Registry (CTR) between 1935 and 1988. Crude, age-adjusted, and age-specific incidence rates of NHL were calculated for each sex. Age-adjusted incidence rates were calculated by the direct method standardized to the 1970 United States standard million population. The data are presented by calendar year and cohort year of birth to examine the secular trends and birth cohort effects. Racial information was not coded before 1957 and is of uncertain validity until the early 1970s; therefore, racial analysis was restricted to 1970-1988. Analyses by histologic subtypes and by anatomic sites were restricted to the last 3 decades (1960-1988) because more accurate classification systems were used during this time.

RESULTS: A total of 11,326 newly diagnosed cases of NHL were included in the study. Of them, 5866 (52%) were diagnosed in men and 5460 (48%) were diagnosed in women. The study results indicated that the incidence rate of NHL has been increasing during the past decades for men and women, whites and blacks, nodular NHL and diffuse NHL, disease originating from lymph nodes and disease originating from other sites, and in all age groups, especially the older age groups. Birth cohort examination did not show any indication of a decline or levelling off in incidence rates among recent birth cohorts. Age-specific incidence rates in both sexes suggested that the rates increase with age, with a sharp increase beginning at 50 years of age and peaking at 80 years of age. Men had a 30% higher incidence rate than women, and whites had approximately 1.5 times the age-adjusted incidence rate of blacks.

CONCLUSIONS: The results indicated that the incidence rate of NHL has been increasing in Connecticut during the past decades and is likely to continue to rise in the coming years. Analytical epidemiologic studies are needed to examine the risk factors that might account for the increase in NHL.