Differences in non-Hodgkin lymphoma survival between young adults and children.

OBJECTIVE To examine differences in non-Hodgkin lymphoma (NHL) survival between young adults and children/adolescents. DESIGN Survival analysis using 13 Surveillance, Epidemiology, and End Results registries. SETTING Cancer survival information from population-based cancer registries from 1992 through 2001. PARTICIPANTS A total of 2442 cases of NHL among children/adolescents (aged 0-19 years) and young adults (aged 20-29 years). MAIN EXPOSURE Differences in NHL survival between young adults and children. MAIN OUTCOME MEASURES Comparison of 5-year survival by constructing Kaplan-Meier survival curves and modeling 5-year survival with multivariate Cox proportional hazards. RESULTS Young adults were more likely to die compared with children/adolescents (hazard ratio = 2.06; 95% confidence interval, 1.65-2.56) even after accounting for NHL subtype and stage at diagnosis. Persons diagnosed with stage III disease (hazard ratio = 1.71; 95% confidence interval, 1.20-2.46) and stage IV disease (hazard ratio = 3.19; 95% confidence interval, 2.47-4.13) were more likely to die compared with persons diagnosed with stage I disease. CONCLUSIONS Being a young adult at diagnosis and having a higher stage of disease at diagnosis were associated with higher risk of death from NHL. Increasing survival with NHL is dependent on receiving appropriate cancer therapy. Therefore, efforts to address survival should include improving enrollment in clinical trials as well as increasing access to care.