Andrews CN et al. - In a study to assess the incidence, risk factors, and endoscopic presentation of gastrointestinal non-Hodgkin's lymphoma (GI NHL) in a large adult population, it was shown that population-based GI NHL incidence rates in Calgary are higher than those described elsewhere in North America or in Britain. The incidence of GI NHL within the HIV population has virtually disappeared, presumably due to the advent of highly active retroviral therapy Methods
A comprehensive database review of all diagnoses of GI NHL in the Calgary Health Region over a 5-yr period was done
Longer-term data from a population-based HIV database were reviewed
A regional pathology database was used to corroborate case identification
All pts 18 yr of age or older were included; age- and gender-adjusted incidence rates were calculated
Within the HIV-positive population, incidence rates were compared over time
Endoscopic appearances were assessed and compared
Results
56 GI NHL cases occurred during the study period
The age- and gender-adjusted annual incidence of GI NHL was 1.73 per 100,000
A majority were diffuse large B-cell histology (54%), followed by lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) (29%)
Increasing age, history of kidney transplant, and H. pylori positivity in MALT lymphoma were identified as risk factors
Within the HIV-positive population, a highly significant drop in GI NHL was seen over time, with an incidence of 3.86 per 1000 patient-years in 1985-1989 compared with 0 cases in 2000-2004, despite a greater prevalence of HIV disease
MALT lymphoma was less likely to manifest as a mass on endoscopy vs other presentations
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