Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network

A Smith, D Howell, R Patmore, A Jack, E Roman, A Smith, D Howell, R Patmore, A Jack, E Roman

Abstract

Background: Ascertainment of cases and disease classification is an acknowledged problem for epidemiological research into haematological malignancies.

Methods: The Haematological Malignancy Research Network comprises an ongoing population-based patient cohort. All diagnoses (paediatric and adult) across two UK Cancer Networks (population 3.6 million, >2000 diagnoses annually, socio-demographically representative of the UK) are made by an integrated haematopathology laboratory. Diagnostics, prognostics, and treatment are recorded to clinical trial standards, and socio-demographic measures are routinely obtained.

Results: A total of 10,729 haematological malignancies (myeloid=2706, lymphoid=8023) were diagnosed over the 5 years, that is, from 2004 to 2009. Descriptive data (age, sex, and deprivation), sex-specific age-standardised (European population) rates, and estimated UK frequencies are presented for 24 sub-types. The age of patients ranged from 4 weeks to 99 years (median 70.6 years), and the male rate was more than double the female rate for several myeloid and lymphoid sub-types, this difference being evident in both children and adults. No relationship with deprivation was detected.

Conclusion: Accurate population-based data on haematological malignancies can be collected to the standard required to deliver reproducible results that can be extrapolated to national populations. Our analyses emphasise the importance of gender and age as disease determinants, and suggest that aetiological investigations that focus on socio-economic factors are unlikely to be rewarding.

Figures

Figure 1
Figure 1
Socio-demographic structure of Haematological Malignancy Research Network (HMRN). (A) Map of study area. (B) Population, age, and sex structure. (C) Office for National Statistics urban/rural definition. (D) Index of multiple deprivation – income domain.
Figure 2
Figure 2
Annual crude rates per 100 000: Haematological Malignancy Research Network (HMRN), 2004–2009.
Figure 3
Figure 3
Age at diagnosis distributions: Haematological Malignancy Research Network (HMRN), 2004–2009.
Figure 4
Figure 4
Sex-rate ratios: Haematological Malignancy Research Network (HMRN), 2004–2009.
Figure 5
Figure 5
Sex-rate ratios by age: Haematological Malignancy Research Network (HMRN), 2004–2009.
Figure 6
Figure 6
Standardised-incidence ratios (SIR) by index of multiple deprivation (IMD) income domain.

References

    1. Alexander DD, Mink PJ, Adami H-O, Chang ET, Cole P, Mandel JS, Trichopoulos D (2007a) The non-Hodgkin lymphomas: a review of the epidemiologic literature. Int J Cancer 120(Suppl 12): 1–39
    1. Alexander DD, Mink PJ, Adami H-O, Cole P, Mandel JS, Oken MM, Trichopoulos D (2007b) Multiple myeloma: a review of the epidemiologic literature. Int J Cancer 120(Suppl 12): 40–61
    1. Allgar VL, Neal RD (2005) Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer. Br J Cancer 92: 1959–1970
    1. Boyle P (2008) World Cancer Report 2008. IARC Press: Lyon
    1. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES (2011) The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 117: 5019–5032
    1. Cancer Research UK (2010) Hodgkin's lymphoma - UK incidence statistics. Available at: (accessed 14 June 2011)
    1. Department of Health (2010) Reducing cancer inequality: evidence, progress and making it happen: a report by the National Cancer Equality Initiative. Available at: (accessed 21 May 2011)
    1. Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer Available at: (accessed 26 August 2010)
    1. Fish EN (2008) The X-files in immunity: sex-based differences predispose immune responses. Nature Rev Immunol 8: 737–744
    1. Friese CR, Abel GA, Magazu LS, Neville BA, Richardson LC, Earle CC (2009) Diagnostic delay and complications for older adults with multiple myeloma. Leuk Lymphoma 50: 392–400
    1. Fritz A (2000) International Classification of Diseases for Oncology: ICD-O, 3rd edn, World Health Organization: Geneva
    1. Harris N, Jaffe E, Stein H, Banks P, Chan J, Cleary M, Delsol G, De Wolf- Peeters C, Falini B, Gatter K (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group (see comments). Blood 84: 1361–1392
    1. Howell DA, Smith AG, Roman E (2006) Lymphoma: variations in time to diagnosis and treatment. Eur J Cancer Care 15: 272–278
    1. Howell DA, Smith AG, Roman E (2008) Help-seeking behaviour in patients with lymphoma. Eur J Cancer Care (Engl) 17(4): 394–403
    1. Jaffe ES (2009) The 2008 WHO classification of lymphomas: implications for clinical practice and translational research. Hematology/the Education Program of the American Society of Hematology. American Society of Hematology. Education Program: 523–531
    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61: 69–90
    1. Jemal A, Siegel R, Xu J, Ward E (2010) Cancer statistics, 2010. CA Cancer J Clin 60: 277–300
    1. Maynadié M, Girodon F, Manivet-Janoray I, Mounier M, Mugneret F, Bailly F, Favre B, Caillot D, Petrella T, Flesch M, Carli P-M (2011) Twenty-five years of epidemiological recording on myeloid malignancies: data from the specialized registry of hematologic malignancies of Cote d’Or (Burgundy, France). Haematologica 96: 55–61
    1. Mozaheb Z, Aledavood A, Farzad F (2011) Distributions of major sub-types of lymphoid malignancies among adults in Mashhad, Iran. Cancer Epidemiol 35: 26–29
    1. National Cancer Intelligence Network (2008) Cancer Incidence and Mortality By Cancer Network, UK, 2005, Available at:
    1. National Cancer Intelligence Network (2009) Cancer Incidence by Deprivation England 1995–2004. Available at: (accessed 16 February 2011)
    1. National Institute for Clinical Excellence (2003) Improving Outcomes in Haematological Cancer: The Manual. National Institute for Clinical Excellence: London
    1. Office for National Statistics (2001) Census: Standard Area Statistics (England). ESRC/JISC Census Programme Census Dissemination Unit, University of Manchester: Manchester
    1. Oliver S, Smith A, Roman E, Bolton E, Ross J, Patmore R, Jack A (2011) Evaluation of the completeness of national haematological malignancy registration: comparison of national data with a specialist population-based register. In BSH 51st Annual Scientific Meeting. British Society for Haematology: Brighton
    1. ONS Geography (2004) Rural/Urban Definition and LA Classification. Available at: (accessed 13 May 2011)
    1. Parkin D (2006) The evolution of the population-based cancer registry. Nature Reviews. Cancer 6: 603–612
    1. Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R (2009) EUROCARE-4. Survival of cancer patients diagnosed in 1995–1999. Results and commentary. Eur J Cancer (Oxford, England: 1990) 45: 931–991
    1. Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, Marcos-Gragera R, Maynadié M, Simonetti A, Lutz J-M, Berrino F (2010) Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 116: 3724–3734
    1. Shack L, Jordan C, Thomson CS, Mak V, Møller H (2008) Variation in incidence of breast, lung and cervical cancer and malignant melanoma of skin by socioeconomic group in England. BMC Cancer 8: 271.
    1. Smith A, Roman E, Howell D, Jones R, Patmore R, Jack A (2010) The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service research. Br J Haematol 148: 739–753
    1. Stata-Corp (2010) STATA 11. Stata-Corp: College Station, TX, USA
    1. Turner JJ, Morton LM, Linet MS, Clarke CA, Kadin ME, Vajdic CM, Monnereau A, Maynadié M, Chiu BC-H, Marcos-Gragera R, Costantini AS, Cerhan JR, Weisenburger DD (2010) InterLymph hierarchical classification of lymphoid neoplasms for epidemiologic research based on the WHO classification (2008): update and future directions. Blood 116: e90–e98
    1. Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, Harris NL, Le Beau MM, Hellström-Lindberg E, Tefferi A, Bloomfield CD (2009) The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 114: 937–951
    1. Westlake S (2009) Cancer incidence and mortality in the United Kingdom and constituent countries, 2004–06. Health Statistics Quarterly/Office for National Statistics: 56–62
    1. WHO (2001) Tumours of Haematopoietic and Lymphoid Tissues. World Health Organisation: Lyon
    1. WHO (2008) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. International Agency for Research on Cancer: Lyon
    1. Yoon SO, Suh C, Lee DH, Chi H-S, Park CJ, Jang S-S, Shin H-R, Park B-H, Huh J (2010) Distribution of lymphoid neoplasms in the Republic of Korea: analysis of 5318 cases according to the World Health Organization classification. Am J Hematol 85: 760–764

Source: PubMed

3
Subskrybuj