Global, regional and national temporal trends in incidence and mortality of non-Hodgkin lymphoma from 1992 to 2021: an age-period-cohort analysis

Abstract Objectives: This study aimed to provide an overview of temporal trends in incidence and mortality of non-Hodgkin lymphoma (NHL) from 1992 to 2021 at global, regional, and national levels, with a special focus on their associations with age, period and cohort. Methods: Data were obtained from the Global Burden of Disease Study 2021. We presented temporal trends in NHL incidence and mortality for the world and 204 countries and territories from 1992 to 2021. An age-period-cohort (APC) model was adopted to estimate net drifts (overall annual percentage change), local drifts (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks. Results: The global age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for NHL were 7.14 (95% uncertainty interval [UI]: 6.58, 7.66) and 3.19 (95% UI: 2.93, 3.44) per 100,000 population in 2021, respectively. From 1992 to 2021, the global net drift of incidence rate was 0.11% (95% confidential intervals [CI]: 0.07%, 0.15%) per year, ranging from - 0.60% (95% CI: -0.66%, -0.54%) in high socio-demographic index (SDI) region to 1.51% (95% CI: 1.46%, 1.57%) in middle SDI region, with 100 countries and territories presenting increasing trends. Similar patterns can be found in the net drift of mortality rate, with 19 countries and territories showing upward trends. Age effects illustrated that incidence and mortality risks progressively increased with advancing age across different SDI regions. Period effects on incidence presented rising risks in high-middle, middle and low-middle SDI regions, whereas on mortality exhibited persistent downward trends in high and high-middle SDI regions. High-middle and middle SDI regions presented initially unfavourable and then favourable trends in incidence and mortality risks across successive birth cohorts. A strong heterogeneity was found in age, period and cohort effects on incidence and mortality across countries. Conclusions: Despite observing an increasing temporal trend in NHL incidence, coupled with a declining trend in mortality, NHL represented a substantial public health challenge worldwide. Temporal trends in NHL were not completely commensurate with socioeconomic development and varied widely across countries. Timely intervention should be conducted, especially for middle-aged and aged individuals.