Hodgkin lymphoma incidence rising in Asia, HK tops global rise in males

The incidence of Hodgkin lymphoma has increased in the past decade, especially in Asian countries, females, and the younger population, a global study has shown.

In the study, researchers from the Chinese University of Hong Kong (CUHK) and Association of Pacific Rim Universities (APRU) evaluated the most recent global distribution in incidence and mortality, risk factors, and epidemiological trends of Hodgkin lymphoma using international databases such as the Global Cancer Observatory (GLOBOCAN), WHO cancer mortality database, Nordic Cancer Registries (NORDCAN), and Surveillance, Epidemiology, and End Results (SEER) Program. [J Hematol Oncol 2022;15:57]

Results showed a global age-standardized incidence of 0.98 per 100,000 population in 2020, with a sixfold variation in geographical distribution. The lowest incidence was found in East Asia (age-standardized rate [ASR], 0.44) and Southeast Asia (ASR, 0.45), while the highest incidence was reported in Southern Europe (ASR, 2.8), Northern Europe (ASR, 2.6), and Australia and New Zealand (ASR, 2.6).

Notably, Asia accounted for three of the seven countries or regions that saw a significant increase in incidence in the male population, as well as five of the nine countries or regions with a significant increase in incidence in the female population.

In males, Hong Kong topped the rise in incidence globally, with an average annual percentage change (AAPC) of +6.23 percent (p=0.025). This was followed by China, with an AAPC of +5.99 percent (p=0.027).

In females, the largest increase in incidence was seen in Ecuador (AAPC, +18.70 percent; p=0.028). In Asian females, the largest increase in incidence was seen in South Korea (AAPC, +8.08; p=0.009). Hong Kong’s AAPC in incidence in females was +5.39 percent (p<0.05).

Large increases in incidence were found in individuals aged ≤40 years, with South Korea topping the rise in males (AAPC, +12.22; p=0.011) and Malta topping the rise in females (AAPC, +13.95; p=0.043). In those ≤50 years of age, the largest increase in incidence was seen in South Korea for both males (AAPC, +9.64; p=0.02) and females (AAPC, +9.02; p=0.012). Hong Kong topped the increase in incidence in males ≥50 years of age (AAPC, +6.95; p=0.022), while Ireland topped the increase in females ≥50 years of age (AAPC, +7.34; p=0.041).

As for mortality, the ASR in 2020 was 0.26 per 100,000 population, with a relatively small geographical variation. The highest mortality rate was in West Asia (ASR, 0.59), while low mortality rates were found in East Asia (ASR, 0.13) and Southeast Asia (ASR, 0.14). An overall decreasing trend in mortality was observed in the past decade, due to advances in and accessibility of treatment.

“Although the incidence of Hodgkin lymphoma was higher in high-income countries or regions, the mortality rate was higher in low-income countries or regions,” pointed out first author, Dr Jun-Jie Huang of Jockey Club School of Public Health and Primary Care, CUHK.