Ruby Arora, MD, is a resident physician of internal medicine in the Department of Medicine at the University of Illinois College of Medicine.

Dr Arora on the Declining Incidence of MCL in the United States

“The incidence of MCL as a whole is declining, [similar to] the overall [decline in the incidence of] non-Hodgkin lymphoma. These are really encouraging data that show us that [the incidence of] MCL, like [that of] other non-Hodgkin lymphomas, is continuing to trend downward in the US."

Ruby Arora, MD, a resident physician of internal medicine in the Department of Medicine at the University of Illinois College of Medicine, discussed findings from a Surveillance, Epidemiology, and End Results (SEER) database analysis showing the overall declining incidence of MCL among people living in the United States (US), as well as ways to address racial disparities in the treatment of patients with MCL.

The first key takeaway from this research is that the incidence of MCL as a whole is declining, similar to the overall downward trend in the rates of non-Hodgkin lymphoma (NHL) in the US, Arora began. This updated SEER analysis collected data from 22 US states between 2000 and 2021. Although the incidence of MCL initially increased between 2000 and 2014, with an annual increase of +2.03%, the trend reversed starting in 2015. Since 2015, the Annual Percent Change analysis indicates an average annual decline of –1.427%, indicating that MCL incidence is declining over time. This is consistent with the overall downward trend in NHL rates, she explained.

Arora also highlighted the importance of focusing on disparities in care, specifically addressing gaps affecting Hispanic and American Indian patients. These groups make up a smaller portion of the total MCL population, making it vital that providers ensure that these patients receive the best care as quickly as possible, she stated. Corresponding subset analyses confirm the persistence of these disparities, noting that the 5-year relative survival rates (RSRs) in Hispanic and American Indian populations continue to be significantly lower than those of other groups, she continued. This disparity reflects continued issues in access to health care or a potentially worse prognosis for these patient populations, she emphasized. 

Overall, these data underscore the necessity of further research to determine why these specific disparities persist and how oncologists can effectively address these gaps in care for Hispanic and American Indian patients, she summarized. Furthermore, the analysis established that there is a dose-response relationship between survival and income. In contrast to the survival rates for Hispanic and American Indian patients, RSRs for Black and Asian/Pacific Islander patients have significantly improved, suggesting better access to care or other unrecognized factors underlying a more favorable prognosis in these groups, she concluded.

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Ruby Arora, MD, discusses ​​the declining incidence of MCL in the US, as well as ways to address disparities that remain in MCL management.

Dr Arora on the Associations Between Income and Race and MCL Survival Outcomes

"When looking at income, we actually found a dose-response relationship between income and survival. As income increased, the RSR increased as well. This demonstrated a dose-dependent relationship between income and survival for [patients with] MCL."

Ruby Arora, MD, a resident physician of internal medicine in the Department of Medicine at the University of Illinois College of Medicine, discussed findings from a study investigating incidence trends, survival outcomes, and sociodemographic disparities among patients with mantle cell lymphoma (MCL) from 2000 to 2021.

Notably, this research demonstrated a statistically significant decrease in MCL incidence rates during the study period, a reversal from the rising incidence rates of the disease that were historically reported.

Several additional factors evaluated in this study yielded noteworthy findings, Arora began. One key focus was the relationship between income and survival outcomes, she said. A clear dose-response association was observed wherein higher income levels correlated with improved relative survival rates (RSRs), she stated. This demonstrated a dose-dependent effect of income on survival among patients with MCL, she clarified.

Another important variable that the study investigators examined was RSR by race and ethnicity, according to Arora. Consistent with previously reported data, the analysis confirmed that certain patient populations—particularly Hispanic and American Indian individuals—continue to experience significantly lower RSRs compared with other groups, she noted. These findings likely reflect ongoing disparities in access to and delivery of care, which unfortunately remain prevalent and were evident in this cohort as well, she reported.

In contrast, the analysis revealed a more encouraging trend when assessing outcomes for Black and Asian/Pacific Islander patients, she explained. Specifically, RSRs in these populations showed evidence of improvement compared with prior reports, she emphasized. These data suggest that some of the historically observed disparities in care for these groups may be beginning to diminish, representing a positive shift in survival outcomes for these patient populations, Arora concluded.

Ruby Arora, MD, discusses a study investigating survival outcomes and sociodemographic disparities among patients with MCL from 2000 to 2021. 

Dr Arora on the Associations Between Income/Race and MCL Survival Outcomes

Dr Arora on A Retrospective Analysis of Temporal Trends to Assess MCL Incidence From 2000-2021

"Looking at incidence, we focused on one main factor called APC, and we were able to statistically define the APC across multiple year sets [i.e., time intervals]."

Ruby Arora, MD, a resident physician of Internal Medicine in the Department of Medicine at the University of Illinois College of Medicine, discussed the design of a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database evaluating temporal trends in mantle cell lymphoma (MCL) incidence from 2000 to 2021. Given that MCL represents a relatively uncommon subtype of non-Hodgkin lymphoma (NHL), accounting for approximately 5% of cases, the SEER database provided the necessary sample size and longitudinal data to allow for robust statistical evaluation of changes in MCL incidence and survival rates across defined time periods, according to Arora.

The analysis used SEER data from 22 US states spanning over 2 decades to quantify annual percent change (APC) trends in incidence rates. APC was assessed across discrete 5-year intervals to determine statistically significant changes in MCL incidence over time. Arora emphasized that stratifying APC by these temporal blocks permitted a more granular and statistically meaningful assessment of evolving epidemiologic patterns.

Findings demonstrated a statistically significant decline in MCL incidence in the most recent 5-year interval compared with preceding periods, Arora said. This downward trend aligns with the broader decline observed in the overall incidence of NHL in the US during the same timeframe. The results suggest that MCL incidence may be following the general epidemiological trajectory of other NHL subtypes, although the biological or environmental factors contributing to this trend were not directly evaluated in this study.

The ability to identify statistically robust shifts in MCL incidence using SEER data strengthens the validity of the findings and supports the use of population-based registries to assess long-term epidemiologic trends in rare lymphoma subtypes. 

Ruby Arora, MD, discusses the design of a retrospective analysis of temporal trends in MCL incidence from 2000 to 2021.

Dr Arora on Findings From a SEER Database Analysis in Mantle Cell Lymphoma

“[These findings] were a new [trend] being reported. In the past, it was reported that the incidence of MCL was increasing, and our data [indicate] that it is actually following the overall [incidence] trend of NHL, which is trending downward.”

Ruby Arora, MD, a resident physician of internal medicine in the Department of Medicine at the University of Illinois College of Medicine, discussed data from an analysis of the Surveillance, Epidemiology, and End Results (SEER) database of patients with mantle cell lymphoma (MCL) presented during the 

To conduct their analysis, Arora and coauthors included data from patients with MCL included in the SEER database from 22 US states from 2001 to 2021. The investigators had previously reported that the rate of MCL incidence has been declining at a statistically significant rate since 2015.

The study authors primarily examined the annual percent change of the incidence of MCL in 5-year periods, Arora began. Data from the study showed that the overall incidence of MCL in the US has continued to decline in a statistically significant manner, she said. These findings are in line with the overall decrease of the incidence of non-Hodgkin lymphoma (NHL), Arora added. In the past, reports had indicated that the incidence of MCL was increasing, but these new data suggest it is following the same downward trend as NHL, she concluded.

Data from the study demonstrated that the annual percentage change in MCL incidence from 2000 to 2014 was 2.03%, but from 2015 to 2021, the annual percentage change was –1.427%. An initial increase in MCL incidence was reported from 0.684 cases per 100,000 individuals per year from 2000 to 2004, to 0.786 cases per 100,000 individuals per year from 2005 to 2009, which then rose to 0.845 cases per 100,000 individuals per year from 2010 to 2014. However, from 2015 to 2019, this figure fell to 0.828 cases per 100,000 individuals per year, fell further to 0.783 cases per 100,000 individuals in 2020, and finally fell to 0.778 cases per 100,000 individuals in 2021.

Ruby Arora, MD, discusses findings from a SEER database analysis of mantle cell lymphoma incidence rates from 2000 to 2021.

Ruby Arora, MD

Articles

Dr Arora on the Declining Incidence of MCL in the United States

Dr Arora on the Associations Between Income/Race and MCL Survival Outcomes

Dr Arora on A Retrospective Analysis of Temporal Trends to Assess MCL Incidence From 2000-2021

Dr Arora on Findings From a SEER Database Analysis in Mantle Cell Lymphoma