Trends and disparities in Non-Hodgkin Lymphoma related mortality in the United States, 1999-2020

Non-Hodgkin Lymphoma (NHL) is the most prevalent hematological malignancy worldwide, making its mortality trends a critical public health concern. This study examines temporal trends in NHL-related mortality in the United States from 1999 to 2020, with a focus on sex-based, racial, and regional disparities.

Data were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Crude and age-adjusted mortality rates (AAMR) were analyzed and annual percentage changes (APCs) were calculated using Joinpoint regression to identify temporal trends.

Among 560,469 NHL-related deaths, AAMR declined from 12.86 (1999) to 8.26 per 100,000 (2020), with an increasing trend from 2018 to 2020 (APC: 0.89 [95% CI, -0.55 to 1.64]). Males consistently exhibited higher mortality rates compared to females (12.62 vs. 7.58), and NH White Americans exhibited the highest mortality among racial groups (10.34). Regional disparities were evident, with the Midwestern region recording the highest AAMR (10.64), and Minnesota, Nebraska, Iowa, Ohio and Vermont exhibiting the highest state-specific rates. Nonmetropolitan areas exhibited higher mortality rates than metropolitan areas (10.28 vs 9.62).

While NHL-related mortality in the U.S. has declined overall, recent upward trends from 2018 to 2020, particularly among certain demographic and geographic subgroups, raise concerns. These findings highlight the need for further investigation into underlying factors and targeted interventions to address disparities and improve NHL outcomes.