Improving Relative Survival, But Large Remaining Differences in Survival for Non-Hodgkin's Lymphoma Across Europe and the United States From 1990 to 2004

Purpose Non-Hodgkin's lymphoma (NHL) is the most common hematologic malignant neoplasm in adults. Monitoring differential changes in population-based survival is across Europe and the United States (US) could point to progress attained and impact of application of novel treatments. Patients and Methods We examined trends in age-specific 5-year relative survival among patients with NHL age 15 years or older between 1990 and 1994 and 2000 and 2004, on the basis of follow-up data from 12 population-based cancer registries across Europe, using period analysis techniques and compared the results with similar trends of patients with NHL in the US, as recorded in the Surveillance, Epidemiology, and End Results database. Results By 2000 to 2004, overall 5-year relative survival of patients with NHL across Europe was between 37% and 62%, achieved by overall increases in 5-year relative survival ranging from 4% to 12% units between 1990 and 1994 and 2000 and 2004. Changes in age-specific survival ranged from -1% to 43% units during the same time interval. For patients with NHL older than age 55 years, relative survival in individual European registries for the whole period was between 8% and 36% units lower than in the US, theoretically representing a lag of 4 to 10 years of progress. Conclusion Our analyses disclosed a strong and ongoing increase in long-term survival for patients with NHL in European populations. The geographic differences potentially indicate that further improvements could be possible, especially for patients age 55 years or older. The presumptive delay in improvement in survival among elderly patients with NHL in Europe remains to be clarified. J Clin Oncol 29:192-199. (C) 2010 by American Society of Clinical Oncology