So far, two juries have determined that Roundup, the most popular weedkiller in the world, causes or significantly contributes to non-Hodgkin lymphoma, a serious, sometimes fatal form of cancer that’s diagnosed in about 74,000 Americans every year.
Accounting for 4 percent of all cancers, non-Hodgkin lymphoma (NHL) is a cancer that starts in the body’s lymphocytes, or white blood cells. These crucial cells are part of the body’s immune system, which helps fight infections and push fluids throughout the body. Lymphoma can begin in any part of the body where lymph tissues are found, such as the lymph nodes, the bone marrow or the spleen.
Of the thousands of lawsuits pending against Roundup and its makers, Monsanto and Bayer AG, many of the plaintiffs have been diagnosed with NHL, including both of the men who were on the receiving end of recent jury verdicts in their favor, with awards topping $150 million in the two cases combined.
While NHL isn’t considered an especially rare form of cancer, it still isn’t as well-understood as some other types of cancer, such as breast or lung cancer. What causes it? Who gets it? Where in the U.S. is it most common? Find the answers to these and other questions below.
What Is Non-Hodgkin’s Lymphoma?
Non-Hodgkin Lymphoma is an umbrella term for many types of blood cancers that share a few specific characteristics. NHL includes all lymphomas that aren’t Hodgkin lymphoma, often referred to as Hodgkin disease or Hodgkin’s disease. There are many types of NHL, and the World Health Organization’s grouping system is the global standard for diagnosing and classifying which type of NHL a patient has.
One of the main factors that guides an NHL diagnosis is which type of white blood cell is affected — B-cells or T-cells. Both types of white blood cells help our bodies fight germs, but B-cell lymphomas are the most common.
Like any cancer, non-Hodgkin lymphoma can cause a series of symptoms, or it may not be noticed by the patient until the cancer is very advanced. But common signals of NHL include:
- Weight loss
- Enlarged lymph nodes
- Swollen belly
- Easy bruising or bleeding
- Chest pain or pressure
- Shortness of breath
- Frequent or severe infections
- Extreme sweats
How Common Is Non-Hodgkin’s Lymphoma?
About 74,200 people will be newly diagnosed with non-Hodgkin lymphoma this year, and nearly 20,000 people will die from it. NHL accounts for about 4 percent of all new cancer cases in a typical year, but it has become much more common over the years.
Here’s a look at the combined incidence rates for men and women between 1975 and 2015, according to the American Cancer Society.
Average incidence rate per 100,000 population
That’s an overall increase in the NHL rate of about 85 percent since the mid-1970s.
Men are more likely than women to be diagnosed, with males accounting for about 55 percent of all new cases of NHL and about 58 percent of deaths caused by the cancer. Men have a 1 in 42 chance of being diagnosed, while women have a 1 in 54 chance.
Non-Hodgkin lymphoma is more common in whites than any other ethnic group, though Hispanics are a close second.
Incidence rates per 100,000 (2011-15) by race or ethnicity
|Alaska Native or Native American||15|
Non-Hodgkin lymphoma rates are highest in the eastern part of the United States. Of the states with the 10 highest incidence of NHL when factoring in population size, only two are outside either New England or the eastern time zone.
New NHL cases per 100,000 population by state
|District of Columbia||17.3|
How Deadly Is Non-Hodgkin’s Lymphoma?
The five-year survival rate for newly diagnosed NHL cases is 71 percent. Newly diagnosed NHL patients have far less of a chance of surviving for five years after diagnosis than those who have Hodgkin lymphoma, as the combined five-year survival rate for that form of lymphoma is 86 percent, 15 percentage points better than the rate for NHL.
Of major cancer types, NHL’s five-year combined survival rate is near the middle of the pack.
Five-year survival rate by cancer type for all stages combined
|Melanoma of the skin||92%|
|Kidney and renal pelvis||74%|
|Oral cavity and pharynx||65%|
|Brain and other nervous system||34%|
|Liver and intrahepatic bile duct||18%|
|Lung and bronchus||18%|
Stages of cancer can be measured by how much, if at all, the cancer has grown from where it originated. Distant cancers are the most aggressive, having spread to parts of the body that are far from where the cancer started. Regional cancers are ones that have spread to nearby areas of the body, and localized cancers haven’t grown beyond their starting points.
NHL five-year survival rate by stage
What Causes Non-Hodgkin’s Lymphoma?
Evidence is mounting that one major factor in the development of non-Hodgkin lymphoma is the weedkiller Roundup and its active ingredient, glyphosate. Quite recently, in February 2019, a meta-analysis of available academic literature indicated that glyphosate exposure raises a person’s risk of non-Hodgkin lymphoma by 41 percent.
While this is just one analysis that attempts to quantify the connection between Roundup and cancer, other similar chemicals have long been believed to be contributing factors. Other risk factors include:
- Genetics: Having a parent, sibling or child with NHL increases your risk
- Radiation: Patients treated with radiation therapy for other cancers have an elevated risk of developing NHL.
- Immune system issues: HIV patients are at an increased risk, as are those who take immunosuppressants after organ transplant. Some autoimmune disorders, such as lupus and rheumatoid arthritis, have been linked with increased NHL risk.
- Infections: There are a handful of infections that can transform the DNA of white blood cells, turning them into cancer cells, including Epstein-Barr virus and herpes virus 8. Additionally, chronic conditions, such as hepatitis C, is a risk factor for some lymphomas.
- Body weight and diet: Being overweight or obese has been detected as a risk factor as has a diet high in fat and meat.
While the U.S. Environmental Protection agency has classified glyphosate as not likely to be carcinogenic, there’s good reason to believe that’s a faulty classification. Nearly 12,000 lawsuits are pending against Monsanto, the company that invented Roundup, and Bayer AG, the German pharma giant that purchased Monsanto in 2018, and two jury verdicts already have tied Roundup use to non-Hodgkin lymphoma.
- American Cancer Society, Cancer Statistics Center. Data retrieved from https://cancerstatisticscenter.cancer.org
- Mutation Research/Reviews in Mutation Research, Exposure to Glyphosate-Based Herbicides and Risk for Non-Hodgkin Lymphoma: A Meta-Analysis and Supporting Evidence. (2019.) https://www.sciencedirect.com/science/article/pii/S1383574218300887
- National Institutes of Health, U.S. National Library of Medicine, Pesticides and non-Hodgkin’s lymphoma. (1992.) Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1394159