Non-Hodgkin Lymphoma: A Tertiary Hospital-Based Study on Clinicopathological Profiles and Trends in North Kerala, India

Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies whose epidemiological and clinicopathological profiles vary significantly across geographical regions. While India presents a distinct profile compared with Western nations, specific regional data, particularly from the high-health-index state of Kerala, remain scarce. The aims of this study were to characterize the clinicopathological features of patients with newly diagnosed NHL treated at the Department of Medical Oncology, Government Medical College, Kozhikode, and to assess the relative frequency and distribution of the various NHL subtypes within this patient population. A retrospective, observational study was conducted on 150 histologically confirmed NHL patients registered between November 2022 and February 2025 at the Department of Medical Oncology, Government Medical College, Kozhikode. Data on demographics, comorbidities, clinical presentation, histological subtypes, staging, and treatment were retrieved and analyzed using descriptive statistics and the chi-square test. The cohort showed a male predominance (66.7%) and a median age of 59 years, which is at the upper end of the range reported in Indian studies. A high proportion of patients belonged to the below poverty line (BPL) category (70.7%) and presented with significant comorbidities, primarily type II diabetes mellitus (24.7%) and hypertension (23.3%). Diffuse large B-cell lymphoma (DLBCL) was the most common subtype (35.33%), followed by follicular lymphoma (FL) at a notably high rate of 28.67%. The majority of patients presented with advanced-stage disease (Stage III/IV: 72%). The NHL profile in North Kerala exhibits a unique blend of Indian and Western characteristics, notably the high prevalence of FL, which is closer to global trends than traditional Indian reports. The high burden of non-communicable comorbidities and advanced-stage presentation underscores the need for patient education and awareness initiatives to facilitate early detection and equitable access to specialized oncology care in this region.