Xie Jing, Xu Jian-She, Huang Jiang-Wei, Zheng Yi-Shan
Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
School of Public Health, Nanjing Medical University, Nanjing, China.
Front Pediatr. 2025 Jun 26;13:1618810. doi: 10.3389/fped.2025.1618810. eCollection 2025.
Childhood non-Hodgkin lymphoma (NHL) is a significant contributor to pediatric cancer morbidity and mortality worldwide. This study aims to assess the global, regional, and national burden of childhood NHL from 1990 to 2021, using data from the Global Burden of Disease (GBD) 2021 study.
Incidence, mortality, and disability-adjusted life years (DALYs) related to childhood NHL were analyzed across 204 countries and 21 geographic regions using standardized methods from the GBD 2021 study. Estimated annual percentage change (EAPC) and average annual percentage change (AAPC) were calculated to evaluate long-term trends. Frontier and inequality analyses were applied to assess the relationship between sociodemographic development and disease burden.
In 2021, there were 20,788.76 (95% uncertainty intervals, UI: 17,199.49-25,305.83) new childhood NHL cases globally, with an incidence rate of 1.03 per 100,000 (95% UI: 0.85-1.26). The global mortality rate decreased from 0.75 (95% UI: 0.57-0.89) in 1990 to 0.45 (95% UI: 0.36-0.56) in 2021 (EAPC: -1.49, 95% confidence interval, CI: -1.60 to -1.39). DALYs rates also declined from 63.38 (95% UI: 48.09-75.72) in 1990 to 37.83 (95% UI: 29.95-47.17) in 2021 (EAPC: -1.51, 95% CI: -1.61 to -1.40). Burden reductions were most significant in high-SDI regions. In contrast, several low- and middle-SDI regions, particularly in Sub-Saharan Africa, experienced either slow declines or rising burden, with Southern Sub-Saharan Africa showing the largest increase in DALYs rate.
While advancements in treatment and healthcare infrastructure have contributed to declining childhood NHL mortality, persistent disparities highlight the need for targeted interventions in low-SDI regions. Strengthening pediatric oncology capacity, expanding treatment accessibility, and enhancing early detection efforts are crucial for reducing global inequalities in childhood NHL outcomes.
儿童非霍奇金淋巴瘤(NHL)是全球儿童癌症发病和死亡的重要原因。本研究旨在利用全球疾病负担(GBD)2021研究的数据,评估1990年至2021年全球、区域和国家儿童NHL的负担。
采用GBD 2021研究的标准化方法,对204个国家和21个地理区域与儿童NHL相关的发病率、死亡率和伤残调整生命年(DALYs)进行了分析。计算估计年百分比变化(EAPC)和平均年百分比变化(AAPC)以评估长期趋势。应用前沿和不平等分析来评估社会人口发展与疾病负担之间的关系。
2021年,全球共有20788.76例(95%不确定区间,UI:17199.49 - 25305.83)儿童NHL新发病例,发病率为每10万人1.03例(95% UI:0.85 - 1.26)。全球死亡率从1990年的0.75(95% UI:0.57 - 0.89)降至2021年的0.45(95% UI:0.36 - 0.56)(EAPC:-1.49,95%置信区间,CI:-1.60至-1.39)。DALYs率也从1990年的63.38(95% UI:48.09 - 75.72)降至2021年的37.83(95% UI:29.95 - 47.17)(EAPC:-1.51,95% CI:-1.61至-1.40)。高社会人口指数(SDI)地区的负担减轻最为显著。相比之下,一些低和中等SDI地区,特别是撒哈拉以南非洲地区,负担下降缓慢或有所上升,撒哈拉以南非洲南部地区的DALYs率上升幅度最大。
虽然治疗和医疗保健基础设施的进步有助于降低儿童NHL死亡率,但持续存在的差距凸显了在低SDI地区进行有针对性干预的必要性。加强儿科肿瘤学能力、扩大治疗可及性以及加强早期检测工作对于减少全球儿童NHL结局的不平等至关重要。