The epidemiological patterns of non-Hodgkin lymphoma: global estimates of disease burden, risk factors, and temporal trends

Yurou Chu; Yingyue Liu; Xiaosheng Fang; Yujie Jiang; Mei Ding; Xueling Ge; Dai Yuan; Kang Lu; Peipei Li; Ying Li; Hongzhi Xu; Juan Fan; Xiangxiang Zhou; Xin Wang

doi:10.3389/fonc.2023.1059914

The epidemiological patterns of non-Hodgkin lymphoma: global estimates of disease burden, risk factors, and temporal trends

Front Oncol. 2023 Jun 2:13:1059914. doi: 10.3389/fonc.2023.1059914. eCollection 2023.

Authors

Yurou Chu¹, Yingyue Liu¹, Xiaosheng Fang², Yujie Jiang², Mei Ding², Xueling Ge², Dai Yuan², Kang Lu², Peipei Li², Ying Li², Hongzhi Xu², Juan Fan², Xiangxiang Zhou^{2

3

4

5}, Xin Wang^{1

2

3

4

5}

Affiliations

¹ Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
² Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
³ Shandong Provincial Engineering Research Center of Lymphoma, Jinan, Shandong, China.
⁴ Branch of National Clinical Research Center for Hematologic Diseases, Jinan, Shandong, China.
⁵ National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, Suzhou, China.

Abstract

Background: The incidence of non-Hodgkin's lymphoma (NHL) has increased steadily over the past few decades. Elucidating its global burden will facilitate more effective disease management and improve patient outcomes. We explored the disease burden, risk factors, and trends in incidence and mortality in NHL globally.

Methods: The up-to-date data on age-standardized incidence and mortality rates of NHL were retrieved from the GLOBOCAN 2020, CI5 volumes I-XI, WHO mortality database, and Global Burden of Disease (GBD) 2019, focusing on geographic disparities worldwide. We reported incidence and mortality by sex and age, along with corresponding age-standardized rates (ASRs), the average annual percentage change (AAPC), and future burden estimates to 2040.

Results: In 2020, there were an estimated 545,000 new cases and 260,000 deaths of NHL globally. In addition, NHL resulted in 8,650,352 age-standardized DALYs in 2019 worldwide. The age-specific incidence rates varied drastically across world areas, at least 10-fold in both sexes, with the most pronounced increase trend found in Australia and New Zealand. By contrast, North African countries faced a more significant mortality burden (ASR, 3.7 per 100,000) than highly developed countries. In the past decades, the pace of increase in incidence and mortality accelerated, with the highest AAPC of 4.9 (95%CI: 3.6-6.2) and 6.8 (95%CI: 4.3-9.2) in the elderly population, respectively. Considering risk factors, obesity was positively correlated with age-standardized incidence rates (P< 0.001). And North America was the high-risk region for DALYs due to the high body mass index in 2019. Regarding demographic change, NHL incident cases are projected to rise to approximately 778,000 by 2040.

Conclusion: In this pooled analysis, we provided evidence for the growing incidence trends in NHL, particularly among women, older adults, obese populations, and HIV-infected people. And the marked increase in the older population is still a public health issue that requires more attention. Future efforts should be directed at cultivating health awareness and formulating effective and locally tailored cancer prevention strategies, especially in most developing countries.

Keywords: epidemiology; global disease burden; incidence; lifestyle; mortality; non-Hodgkin lymphoma.

Grants and funding

This study was supported by National Natural Science Foundation (No.82270200, No.82170189, No.82070203, No.81800194, No.81770210); Key Research and Development Program of Shandong Province (No.2018CXGC1213); China Postdoctoral Science Foundation (No. 2021T1404223); Translational Research Grant of NCRCH (No.2021WWB02, No.2020ZKMB01); Shandong Provincial Natural Science Foundation (ZR2021YQ51); Taishan Scholars Program of Shandong Province; Shandong Provincial Engineering Research Center of Lymphoma; Academic Promotion Programme of Shandong First Medical University (No. 2019QL018).