Winship Cancer Institute, Atlanta, GA.
Winship Cancer Institute, Atlanta, GA; Rollins School of Public Health, Emory University, Atlanta, GA.
Clin Lymphoma Myeloma Leuk. 2019 Nov;19(11):699-708.e5. doi: 10.1016/j.clml.2019.06.009. Epub 2019 Jun 26.
Racial disparities in non-Hodgkin lymphoma (NHL) are not well-elucidated for specific catchment areas, which can influence outcomes. Leveraging regional data from a population-based cancer registry may provide unique opportunities to quantify NHL disparities.
Using Surveillance, Epidemiology, and End Results (SEER) data for NHL cases diagnosed in Georgia from 2001 to 2015, we examined NHL incidence rates by lymphoma subtype and racial differences in baseline characteristics and outcomes for diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Cox regression models identified predictors of overall survival (OS).
SEER documented 38,504 NHL cases in Georgia from 2001 to 2015. The age-adjusted incidence rate for NHL in Georgia increased 1.03% per year, and the annual percentage change was 1.72 in blacks compared with 0.84 in whites. Compared with whites, blacks with DLBCL and FL were more likely to be diagnosed at a younger age (DLBCL, 54.1 vs. 65.5 years; P < .0001; FL, 58.4 vs. 64.0 years; P < .0001) and with B symptoms (DLBCL, 44.4% vs. 33.4%; P < .0001; FL, 28.5% vs. 21.4%; P = .004). Across racial categories, age at diagnosis > 60 years, advanced stage, and B symptoms predicted worse OS in DLBCL and FL. Blacks with DLBCL more commonly were diagnosed with stage III/IV disease (55.5% vs. 48.1%; P < .0001) and had worse 5-year relative survival (58.8% vs. 62.3%; P = .01).
Regional cancer registry data can be used to define incidence patterns and disparities in outcomes across NHL subtypes to help define key targets for interventions in a catchment area.
非霍奇金淋巴瘤（NHL）在特定的普查区域内种族差异尚未得到充分阐明，而这些差异可能会影响预后。利用基于人群的癌症登记处的区域数据可能为量化 NHL 差异提供独特的机会。
我们使用 2001 年至 2015 年期间佐治亚州监测、流行病学和最终结果（SEER）数据库中诊断的 NHL 病例数据，通过淋巴瘤亚型和弥漫性大 B 细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤（FL）的基线特征和结局的种族差异，检查 NHL 的发病率。Cox 回归模型确定了总生存（OS）的预测因素。
SEER 在 2001 年至 2015 年期间记录了佐治亚州的 38504 例 NHL 病例。佐治亚州 NHL 的年龄调整发病率每年增加 1.03%，而黑人的年变化率为 1.72%，白人则为 0.84%。与白人相比，患有 DLBCL 和 FL 的黑人更有可能在较年轻时被诊断出（DLBCL，54.1 岁对 65.5 岁；P <.0001；FL，58.4 岁对 64.0 岁；P <.0001）且有 B 症状（DLBCL，44.4%对 33.4%；P <.0001；FL，28.5%对 21.4%；P =.004）。在各种种族类别中，年龄 > 60 岁、晚期疾病和 B 症状预测 DLBCL 和 FL 的 OS 更差。患有 DLBCL 的黑人更常见地被诊断为 III/IV 期疾病（55.5%对 48.1%；P <.0001），并且 5 年相对生存率更差（58.8%对 62.3%；P =.01）。
区域癌症登记处的数据可用于定义 NHL 亚型的发病模式和结局差异，以帮助确定普查区域内干预的关键目标。
