Cancer Causes & Control

, Volume 26, Issue 8, pp 1153–1162 | Cite as

US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma

  • Erin E. Kent
  • Nancy Breen
  • Denise R. Lewis
  • Janet S. de Moor
  • Ashley Wilder Smith
  • Nita L. Seibel
Original paper



Improvement in US survival rates among adolescents and young adults (AYAs, ages 15 through 39 years inclusive) diagnosed with non-Hodgkin lymphoma (NHL) has been documented over the last two decades. We examined national trends in survival disparities for AYAs with NHL by race/ethnicity and socioeconomic status (SES, county-level poverty) to further understand NHL and to begin monitoring health outcome disparities for this disease.


Surveillance Epidemiology and End Results data were used to calculate 5-year relative survival rates of AYAs diagnosed with NHL from 1992 to 2007 and followed through 2011. Absolute and relative disparities were computed using HD*Calc. Whether a significant linear trend was present was evaluated using Joinpoint. Analyses were replicated after excluding individuals with known HIV infection.


The study sample included 9,573 total and 7,121 non-HIV cases of NHL. Five-year survival rates improved for all groups over time. Significant decreases were found in absolute disparities for race/ethnicity (non-HIV), in relative disparities for SES (total) and race/ethnicity (total and non-HIV) (all p < 0.05). Survival rates of non-Hispanic Blacks and Hispanics remained below than those of non-Hispanic Whites throughout the time period.


Absolute and relative disparities in 5-year survival narrowed for AYAs with NHL over the time period. To continue to promote this trend, future research should investigate factors, particularly diagnostic delays and barriers to care, which continue to contribute to SES and racial/ethnic differences in survival. These factors may be particularly relevant to identify given the recent Affordable Care Act, which is designed to increase access to medical services, particularly for young adults.


Non-Hodgkin lymphoma Adolescents and young adults Relative survival Cancer health disparities Surveillance 


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Copyright information

© Springer International Publishing Switzerland (outside the USA) 2015

Authors and Affiliations

  1. 1.Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteRockvilleUSA
  2. 2.Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteRockvilleUSA
  3. 3.Data Quality, Analysis, and Interpretation Branch, Surveillance Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteRockvilleUSA
  4. 4.Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteRockvilleUSA
  5. 5.Clinical Investigations Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and DiagnosisNational Cancer InstituteRockvilleUSA

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