Document Type

Capstone Experience

Graduation Date

12-2019

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Shinobu Watanabe-Galloway

Second Committee Member

Lynette Smith

Abstract

Background: Non-Hodgkin lymphomas (NHL) are a group of diverse and complex cancers of the lymphocytes. More than 60 subtypes have been identified based on certain characteristics of the cancer cell. The objectives of this study were to: 1) determine NHL age-adjusted incidence rates from 2000 to 2015 in the U.S. by age, sex, and race/ethnicity; 2) to examine age-adjusted subtype-specific NHL incidence rates by age, sex, and race/ethnicity; 3) to determine if there was significant time trend in age-adjusted NHL incidence rate from 2000-2015 in the U.S by age, sex, and race/ethnicity.; 4) and to examine time trend in age-adjusted subtype-specific NHL incidence rate from 2000-2015 in the U.S. by age, sex, and race/ethnicity.

Methods: We used Surveillance Epidemiology and End Results (SEER) Program registries of 18 geographical locations 2000-2015. There were a total of 259,228 incident cases of NHL. Subtypes were coded using the World Health Organization (WHO) 2008 classification scheme and International Classification of Disease – Oncology, 3rd Edition (ICD-O-3) site codes. Subgroups analyzes were based on sex, race (white, black, American Indian/Alaska Native, or Asian/Pacific Islander), ethnicity (non-Spanish/Hispanic/Latino or Spanish/Hispanic/Latino) and age group (20-29, 30-39, 40-49, 50-59, 60-69, or 70+). Age-adjusted incidence rates and rate ratios were calculated using SEER*Stat software. Statistical significance was determined by comparing 95% confidence intervals. Annual percentage change (APC) was calculated using Joinpoint regression software.

Results: All subtypes had decreasing incidence except mantle-cell lymphoma, which had increasing incidence (APC 0.77%, p

Conclusion: Analysis by subtype and subgroups revealed incidence rates and time trends that were not obvious when analyzing data for all subtypes of subpopulations combined. Some subgroups were at higher risk than others, but only for certain subtypes, meaning that etiology and risk may vary by subtype. This was apparent in the higher risk for blacks compared to whites in T-cell lymphomas and Hispanics compared to non-Hispanics in diffuse large B-cell lymphoma and Burkitt lymphoma. Understanding these differences can help us identify population-specific prevention methods and treatments for each subtype.

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