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Comparative Study
. 2012 Jun;87(6):573-8.
doi: 10.1002/ajh.23187. Epub 2012 Apr 10.

Pediatric, elderly, and emerging adult-onset peaks in Burkitt's lymphoma incidence diagnosed in four continents, excluding Africa

Sam M Mbulaiteye  1 , William F Anderson, Jacques Ferlay, Kishor Bhatia, Cindy Chang, Philip S Rosenberg, Susan S Devesa, Donald M Parkin
Affiliations
Comparative Study

Pediatric, elderly, and emerging adult-onset peaks in Burkitt's lymphoma incidence diagnosed in four continents, excluding Africa

Sam M Mbulaiteye et al. Am J Hematol. 2012 Jun.

Abstract

Burkitt's lymphoma (BL) in the general population and immunosuppressed persons with AIDS in the United States was characterized by three age-specific incidence peaks near 10, 40, and 70 years. We hypothesized that BL from different geographical areas may exhibit pediatric, adult, and elderly age incidence peaks. We investigated this hypothesis using data on 3,403 cases obtained from the International Agency for Research on Cancer (1963-2002). Data from Africa were sparse or incomplete, and thus were excluded. Age-standardized rates (ASRs) and age-specific incidence rates were calculated, supplemented with the calculations performed using age-period-cohort (APC) models. The ASR rose 5.3% (95% confidence interval [CI], 5.0-5.6) per year in males and 4.6% (95% CI, 4.5-4.8) in females. The ASR increased gradually in children, steeply in adults and most rapidly in the elderly both in males and in females. Overall, BL male/female ASR ratio was 2.5, but it declined from 3.1 (95% CI, 3.0-3.3) for pediatric BL to 2.3 (95% CI, 2.2-2.4) for adult BL and 1.5 (95% CI, 1.4-1.6) for elderly BL. Age-specific incidence peaks occurred near 10 and 70 years in all regions and periods. A peak near 40 years of age emerged in the mid-1990s, particularly in men. Findings using APC models confirmed those based on the standard analyses. Our findings, based on the international BL cases, support our hypothesis that BL is multimodal and that BL peaks at different ages may be clues to differences in the etiology and/or biology of BL at those ages.

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Conflict of interest statement

Conflict of interest

None declared.

Figures

Figure 1
Figure 1
Burkitt lymphoma age-adjusted (world standard) incidence trends. Incidence from 1978–1982 through 1998–2002 for males (solid squares) and females (open circles) of all ages (Panel A); for pediatric (0–19 years), adult (20–59 years), and elderly (60+ years) BL in males (Panel B) and in females (Panel C), based on data reported in Cancer Incidence in Five Continents Volumes V to IX. Numbers in parentheses in the panel legends are estimated annual percentage change and 95% CI.
Figure 2
Figure 2
Burkitt lymphoma age-specific incidence rates. Rates for males (Panel A) and females (Panel B) during two 10-year calendar periods (1978–1987, 1988–1997) and one 5-year calendar period (1998–2002), based on data reported in Cancer Incidence in Five Continents Volumes V to IX.
Figure 3
Figure 3
Fitted local drifts (circles connected by a dotted line) for males (Panel A) and females (Panel B) during 1978 through 2002, based on data reported in Cancer Incidence in Five Continents Volumes V to IX. The local drifts are bounded by 95% confidence bands. The dotted line depicts the global drift for all ages combined. Conceptually, local drifts are similar, but not numerically equivalent, to the estimated age-specific annual percentage change of the ASR (see methods).
Figure 4
Figure 4. Burkitt lymphoma age-specific male-to-female rate ratios during 1978–2002
Ratios based on data reported in Cancer Incidence in Five Continents Volumes V to IX.
See this image and copyright information in PMC

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