Distinctive incidence patterns of follicular lymphoma in Taiwan: Implications of ethnic differences

Shang Ju Wu, Yi Chu Chen, Wei Cheng Lo, Chun Ju Chiang, Chien Ting Lin, Shih Sung Chuang, Mei Shu Lai

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Follicular lymphoma (FL) is less prevalent in Asians, but detailed epidemiological analyses were not available. This study aimed to characterize the epidemiologic features of FL in Taiwan to explore the factors relevant to disease development and prognosis. Methods: We obtained epidemiological data for Taiwanese citizens during 1990-2012 from Taiwan's National Cancer Registry Database, and the corresponding data for US Caucasians from the Surveillance, Epidemiology, and End Results Program. Changes in incidence rates were evaluated with age-period-cohort (APC) analyses. Patient outcomes were compared with 5-year relative survival rates (RS) estimates. Results: Incidence rates of FL in Taiwan increased continuously during the study period (0.34 to 0.91 per 100 000 person-year from 1993-1997 to 2008-2012 in men, and from 0.29 [1993-1997] to 0.81 [2008-2012] in women), while rates in the US remained stable in both sexes, ranging between 3.73 and 3.96 in men and between 3.24 and 3.55 in women. Estimates of average annual percentage changes in incidence were significantly positive in Taiwan, but not in US Caucasians. Notably, the APC analysis identified a strong birth-cohort effect in Taiwan, corresponding to environmental alterations present during the study period. The estimated 5-year RS rates in both populations showed steady improvement, but the RS in Taiwanese patients was consistently 10% lower than in US Caucasians. Conclusion: A distinct increasing trend of incidence with a strong birth-cohort effect was identified in Taiwan, providing evidence of the association between environmental factors and disease development.

Original languageEnglish
Pages (from-to)1899-1907
Number of pages9
JournalCancer Medicine
Issue number4
Publication statusPublished - Apr 2019


  • age-period-cohort model
  • epidemiology
  • follicular lymphoma
  • incidence
  • survival
  • Taiwan

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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