Disparities by race, age, and sex in the improvement of survival for lymphoma: Findings from a population-based study

Objective To evaluate improvement in survival of lymphoma patients from 1990 to 2014, stratified by age, sex and race using Surveillance Epidemiology and End-Result Survey Program (SEER) data. Study design and setting We identified 113,788 incident lymphoma cases from nine SEER cancer registries were followed up for cause-specific mortality from lymphoma. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and their respective 95% confidence interval (CIs) for various time periods within groups stratified by race, age and sex. Results Five-year survival for Hodgkin’s lymphoma (HL) was 89% for patients 20–49 years of age. For this age group, compared to 1990–1994, survival significantly improved in 2000–2004 (HR = 0.65; 95% CI: 0.54–0.78), 2005–2009 (HR = 0.46, 95% CI: 0.38–0.57) and 2010–2014 (HR = 0.29, 95% CI: 0.20–0.41). Hodgkin’s lymphoma patients aged 75–85 years had 5-year survival of 37% and in these patients, compared to 1990-1994, survival only improved from 2005 onward (HR = 0.67, 95% CI: 0.50–0.90). In patients with non-Hodgkin’s Lymphoma (NHL), all age groups showed survival improvements between 1990–1994 period and 2010–2014 period. Improvements in HL and NHL survival were seen for all race categories and both genders. Conclusion Survival among US lymphoma patients has improved substantially between 1990–1994 period and 2010–2014 period, though disease-specific mortality was still higher in older age groups. © 2018 Mukhtar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited