Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection
Abstract Follicular lymphoma (FL) is usually diagnosed at an advanced stage when the patient presents with a palpable lymph node or symptoms such as pain and fatigue. However, due to advances in imaging techniques used for many diseases and cancer screening, incidental diagnosis of FL is expected to...
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Nature Publishing Group
2025-07-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-025-01322-9 |
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| author | Suheil Albert Atallah-Yunes Matthew J. Rees Raphael Mwangi Robyn L. Kuchler Ahmed Alnughmush Grzegorz S. Nowakowski Thomas M. Habermann Yucai Wang Jose C. Villasboas Bisneto Andrew L. Feldman Matthew J. Maurer James R. Cerhan Stephen M. Ansell Thomas E. Witzig |
| author_facet | Suheil Albert Atallah-Yunes Matthew J. Rees Raphael Mwangi Robyn L. Kuchler Ahmed Alnughmush Grzegorz S. Nowakowski Thomas M. Habermann Yucai Wang Jose C. Villasboas Bisneto Andrew L. Feldman Matthew J. Maurer James R. Cerhan Stephen M. Ansell Thomas E. Witzig |
| author_sort | Suheil Albert Atallah-Yunes |
| collection | DOAJ |
| description | Abstract Follicular lymphoma (FL) is usually diagnosed at an advanced stage when the patient presents with a palpable lymph node or symptoms such as pain and fatigue. However, due to advances in imaging techniques used for many diseases and cancer screening, incidental diagnosis of FL is expected to rise. In this study, we investigated FL disease characteristics and outcomes in patients diagnosed incidentally versus symptomatically, providing insights into what might be detected with multi-cancer early detection tests (MCEDs). We conducted a review of 908 patients with newly diagnosed FL enrolled in the Mayo Clinic component of the Molecular Epidemiology Resource (MER) from 2002 to 2015. We compared disease characteristics and outcomes between the incidental and symptomatic groups. Of the 908 patients, 259 (28.5%) were diagnosed incidentally. The incidental group was more likely to present with early-stage disease (stage I/II: 43.2% vs. 30.6%, p = 0.0003), normal lactate dehydrogenase (LDH) levels (87.2% vs. 80.8%, p = 0.03), and trended towards having lower FLIPI scores (49.8% vs. 42.2%, p = 0.1). However, there were no significant differences in event-free survival (EFS), overall survival (OS) or lymphoma-specific survival (LSS) between the two groups. In conclusion, incidental detection of FL is associated with earlier stages and more favorable disease characteristics. However, this did not translate into improved survival outcomes. Whether even earlier detection of FL using emerging MCEDs translates into improved outcomes remains an open question requiring further investigation. |
| format | Article |
| id | doaj-art-7f3b1a12835541758ddf3547dd6767d1 |
| institution | Kabale University |
| issn | 2044-5385 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj-art-7f3b1a12835541758ddf3547dd6767d12025-08-20T03:45:19ZengNature Publishing GroupBlood Cancer Journal2044-53852025-07-011511610.1038/s41408-025-01322-9Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detectionSuheil Albert Atallah-Yunes0Matthew J. Rees1Raphael Mwangi2Robyn L. Kuchler3Ahmed Alnughmush4Grzegorz S. Nowakowski5Thomas M. Habermann6Yucai Wang7Jose C. Villasboas Bisneto8Andrew L. Feldman9Matthew J. Maurer10James R. Cerhan11Stephen M. Ansell12Thomas E. Witzig13Division of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicAlix School of Medicine, Mayo ClinicDivision of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicDepartment of Laboratory Medicine and Pathology, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicDivision of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicAbstract Follicular lymphoma (FL) is usually diagnosed at an advanced stage when the patient presents with a palpable lymph node or symptoms such as pain and fatigue. However, due to advances in imaging techniques used for many diseases and cancer screening, incidental diagnosis of FL is expected to rise. In this study, we investigated FL disease characteristics and outcomes in patients diagnosed incidentally versus symptomatically, providing insights into what might be detected with multi-cancer early detection tests (MCEDs). We conducted a review of 908 patients with newly diagnosed FL enrolled in the Mayo Clinic component of the Molecular Epidemiology Resource (MER) from 2002 to 2015. We compared disease characteristics and outcomes between the incidental and symptomatic groups. Of the 908 patients, 259 (28.5%) were diagnosed incidentally. The incidental group was more likely to present with early-stage disease (stage I/II: 43.2% vs. 30.6%, p = 0.0003), normal lactate dehydrogenase (LDH) levels (87.2% vs. 80.8%, p = 0.03), and trended towards having lower FLIPI scores (49.8% vs. 42.2%, p = 0.1). However, there were no significant differences in event-free survival (EFS), overall survival (OS) or lymphoma-specific survival (LSS) between the two groups. In conclusion, incidental detection of FL is associated with earlier stages and more favorable disease characteristics. However, this did not translate into improved survival outcomes. Whether even earlier detection of FL using emerging MCEDs translates into improved outcomes remains an open question requiring further investigation.https://doi.org/10.1038/s41408-025-01322-9 |
| spellingShingle | Suheil Albert Atallah-Yunes Matthew J. Rees Raphael Mwangi Robyn L. Kuchler Ahmed Alnughmush Grzegorz S. Nowakowski Thomas M. Habermann Yucai Wang Jose C. Villasboas Bisneto Andrew L. Feldman Matthew J. Maurer James R. Cerhan Stephen M. Ansell Thomas E. Witzig Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection Blood Cancer Journal |
| title | Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection |
| title_full | Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection |
| title_fullStr | Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection |
| title_full_unstemmed | Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection |
| title_short | Incidental vs. symptomatic diagnosis of follicular lymphoma: implications of earlier detection |
| title_sort | incidental vs symptomatic diagnosis of follicular lymphoma implications of earlier detection |
| url | https://doi.org/10.1038/s41408-025-01322-9 |
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