Background: The introduction of rituximab in the early 2000 s has revolutionized the management of diffuse large B‐cell lymphoma (DLBCL). Findings from our prior population‐based study in the Netherlands among DLBCL patients diagnosed up to 2010 showed an improvement in outcome since R‐CHOP was implemented in 2003 (Issa et al., Haematologica , 2015). Aims: Here, we extend our prior population‐based study with patients diagnosed up to 2016. This with the aim of assessing whether treatment practices changed and survival of DLBCL patients continues to increase in a contemporary era with well‐established therapy with R‐CHOP. Methods: We selected all adult (≥18 years) DLBCL patients diagnosed between 1989–2016 from the nationwide Netherlands Cancer Registry (NCR), with survival follow‐up up to January, 2018. Data on primary therapy—i.e. no therapy, radiotherapy (RT) alone, treatment with a chemotherapeutic (CT) backbone without RT and CT+RT,—were available in the NCR. Of note, information on rituximab use was only available in the NCR for patients diagnosed from 2007. We calculated relative survival rates (RSRs) and excess mortality ratios (EMRs) up to five years after diagnosis to estimate disease‐specific survival. All analyses were separately performed for patients with stage I (n = 6,534; median age, 68 years) and stages II‐IV DLBCL (n = 18,609; median age, 68 years), and stratified by time period (1989–2002, 2003–2010, and 2011–2016) and age (18–64, 65–74, and ≥75 years). The periods were selected based on the availability of rituximab in the Netherlands. Results: Treatment with RT alone decreased between 1989–2002 and 2003–2010 among patients with stage I DLBCL across all three age groups, following the wider application of CT+RT (Fig 1A). This trend was, less pronounced between 2003–2010 and 2011–2016 (Fig 1A). There were no major trends over time across the three age groups for the remaining treatment groups (Fig 1A). Most patients with stage II‐IV DLBCL, received CT without RT throughout the entire study ...