Racial disparities in Hodgkin's lymphoma: a comprehensive population-based analysis

Racial disparity has been investigated in a number of cancers; however, there remains a comparative paucity of data in Hodgkin's lymphoma (HL). We examined time-, age-, and gender-specific incidence, disease characteristics, and survival across and within races for adolescent/adult HL (age 10-79 years) diagnosed during 1992-2007 in the SEER 13 registries. A total of 15 662 HL cases were identified [11 211 non-Hispanic whites, 2067 Hispanics, 1662 blacks, and 722 Asian/Pacific Islanders (A/PI)]. Similar to whites, A/PIs had bimodal age-specific incidence, while blacks and Hispanics did not. Further, HL was significantly more common in Hispanics versus whites age > 65 years (7.0/1 x 10(6) versus 4.5/1 x 10(6), respectively, P < 0.01). By place of birth, US-born Hispanics and A/PIs age 20-39 years had higher incidence of HL versus their foreign-born counterparts (P < 0.05), however, rates converged age > 40 years. Interestingly, from 1992-1997 to 2003-2007, A/PI incidence rates increased > 50% (P < 0.001). Moreover, this increase was restricted to US-born A/PI. We also identified a number of disease-related differences based on race. Finally, 5-, 10-, and 15-year overall survival rates were inferior for blacks and Hispanics compared with whites (P < 0.005 and P < 0.001, respectively) and A/PI (P < 0.018 and P < 0.001, respectively). These differences persisted on multivariate analysis. Collectively, we identified multiple racial disparities, including survival, in adolescent/adult HL.