More Women Will Be Diagnosed With MCL Through 2032, SEER Data Suggest

Recent data from the National Cancer Institute (NCI) suggest that the number of people in the US diagnosed with diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL) will rise through 2032, with treatment-eligible patient counts growing as well, creating new challenges for the health system and payer budgeting.

Those were conclusions from authors from Merck, who have just published a study in Cancer Treatment and Research Communications,¹ which projects “a marked increase in the incidence, prevalence, and number of treatment-eligible patients with DLBCL and MCL by [line of therapy] over the next several years,” which will bring “a rise in disease burden, demand for treatment access, and the need for advanced therapeutic and biomarker-driven strategies.”¹

The analysis draws on NCI’s Surveillance, Epidemiology, and End Results (SEER) data, specifically SEER-21 incidence data from 2017 to 2022 and SEER-Medicare claims from 2012 to 2021, and projects trends through 2032. For DLBCL, already the most common non-Hodgkin lymphoma (NHL) subtype at roughly 30% of cases, incidence is projected to rise 7%, from approximately 28,800 new cases annually in 2023 to nearly 30,800 by 2032. The treatment-eligible population follows accordingly, with first-line patients increasing from 33,120 to 35,523 and later lines growing by roughly 8%.

For MCL, a less common subtype the authors say has been understudied, the trends appear more complex. Overall incidence is projected to grow 6%, from 3377 to 3589 cases annually, but the demographic composition is shifting in ways that will challenge existing care models. The authors project a 43% increase in MCL among women over the decade, from 920 to 1318 new cases per year, alongside a 33% increase among patients under age 65. As they note, these patterns “suggest potential shifting epidemiological patterns that may influence disease burden and healthcare priorities.”

The treatment-eligible MCL population is projected to grow 6% across all lines: from 3376 to 3591 in first line, and from 1220 to 1297 in second line, 685 to 729 in third, and 379 to 403 in fourth. While the absolute numbers are smaller than DLBCL, MCL's notoriously challenging treatment landscape, which involves Bruton tyrosine kinase (BTK) inhibitors, immunochemotherapy induction, autologous stem cell transplantation (ASCT), and, increasingly, chimeric antigen receptor (CAR) T-cell therapy, requires resource-intensive, individualized care for each patient.

The implications for Medicare are significant and directly embedded in the study's methodology. SEER-Medicare data reveals that among diagnosed MCL patients, 62.3% receive first-line systemic therapy, with 45.5% of those advancing to second line, 47.4% to third, and 46.7% to fourth. These rates reflect a population that cycles through multiple costly regimens. The SEER-Medicare cohort—fee-for-service beneficiaries aged 66 and older—is precisely the population driving MCL prevalence growth, with older adults currently comprising 2390 of 3377 new annual cases.

The authors acknowledge that recent approvals, including second-generation BTK inhibitors zanubrutinib (Brukinsa; BeOne Medicines) and acalabrutinib (Calquence; AstraZeneca) and CAR T-cell therapies, may shift future line-of-therapy distributions in ways that historical claims data cannot fully anticipate; this limitation has direct relevance to formulary planning and medical benefit design. “In MCL, historically poor prognosis has been transformed by advances such as immunochemotherapy induction with cytarabine and anti-CD20 antibodies, consolidative ASCT, and rituximab maintenance, particularly benefiting older patients,” they write.

As the study concludes, these projections underscore "the growing healthcare burden in the US" and point to an increasing demand for effective treatment options at each stage of care—a demand that Medicare, as the dominant payer in this predominantly older population, will be disproportionately positioned to absorb.

Reference

Lin D, Shao C, Ma J, Burcu M, Sineshaw HM. Projected disease burden and treatment eligibility of patients with diffuse large B-cell and mantle cell lymphoma in the United States over the next decade. Cancer Treat Res Commun. 2026;48:101291. doi: 10.1016/j.ctarc.2026.101291.