Global Patterns, Temporal Trends, and Potential Non-Infectious Risk Factors for Burkitt Lymphoma from 1990 to 2021

The heterogeneity in the health burden and non-infectious risk factors of Burkitt lymphoma (BL) across sex, age, and geographic distribution remain inadequately understood.

Based on Global Burden of Disease study 2021, we estimate the health burden of BL from four metrics: incidence, mortality, prevalence, and disability-adjusted life years. Subgroups were stratified by age, sex, region, and socio-demographic index (SDI). Joinpoint regression was used to evaluate the average annual percentage change (AAPC) to quantify trends in the health burden. Predictions were performed using the Bayesian age-period-cohort model. Non-infectious risk factors were identified and analyzed utilizing summary exposure values (SEVs) to assess their impact on BL incidence and mortality.

The estimated global incident number of BL was 19,073 (95% CI: 9651 to 32,509) in 2021, nearly threefold that of 1990. The health burden of BL was markedly higher in males than females, especially among individuals aged under 20 years. From 1990 to 2021, the most significant increasing trend in BL health burden was observed in Cabo Verde, while Georgia exhibited the most notable decline. From 2021 to 2040, the global age-standardized incidence and mortality rates were projected to decline by 14.7% and 24.7%, respectively. Conversely, the health burden on individuals aged 20 to 54 years was anticipated to rise through 2040. In our study, low bone mineral density was found to be linked with elevated risk for males aged over 54 years, while childhood sexual abuse exhibited a paramount positive association with BL risk for females, regardless of age. Notably, tobacco use, particularly secondhand smoking, were inversely associated with BL risk across all age groups and sexes.

Burkitt lymphoma demonstrated unique distribution patterns in terms of age, sex, and region. Further investigations into the heterogeneity of the risk factors for BL are essential for the development of more effective health policies and clinical practices.