title: Trends in excess mortality in follicular lymphoma at a population level.
abstract: BACKGROUND
  Since the 1990s and since the development of humanised monoclonal antibodies in 1998, the treatment of non-Hodgkin lymphoma has undergone profound changes. Follicular lymphoma (FL) was the first to benefit from this treatment, and several clinical trials have shown a significant improvement in overall survival, but little information is available at a population level.
  
  
  OBJECTIVE
  Our objective was to estimate changes in FL-specific mortality at a population level, with an appropriate methodology.
  
  
  METHODS
  Two French retrospective population-based studies on FL were conducted, one from 1995 to 2004, in 1477 patients, and one from 1995 to 2010, in 451 patients. Trends in excess mortality rates (EMRs) according to age, sex, Ann Arbor stage and year of diagnosis were evaluated using the flexible model of Remontet et al.
  
  
  RESULTS
  Trends in the EMR differed according to age at diagnosis and was higher in advanced stage (III, IV) in patients older than 65 yr. The EMR decreased linearly from 1995 to 2010. This decrease was more marked for advanced stages.
  
  
  CONCLUSIONS
  FL-specific mortality decreased over the years of diagnosis, and the difference according to the lymphoma stage diminished in more recent years. However, progress in the management of FL was not able to erase age-related differences.
authors: Registre des Hémopathies Malignes de Côte d'Or, EA 4184, Université de Bourgogne, Dijon, France.
authors: Morgane
authors: M
authors: Mounier
authors: Nadine
authors: N
authors: Bossard
authors: Aurélien
authors: A
authors: Belot
authors: Laurent
authors: L
authors: Remontet
authors: Jean
authors: J
authors: Iwaz
authors: Mylène
authors: M
authors: Dandoit
authors: Stéphanie
authors: S
authors: Girard-Boulanger
authors: Aurélie
authors: A
authors: Herry
authors: Anne-Sophie
authors: AS
authors: Woronoff
authors: René-Olivier
authors: RO
authors: Casasnovas
authors: Marc
authors: M
authors: Maynadié
authors: Roch
authors: R
authors: Giorgi
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000453:epidemiology / Q000266:history / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult
keywords: excess mortality; follicular lymphoma; immunotherapy; population-based study