International variations in lymphoma incidence in children and adolescents

To compare the subtype distribution of lymphoma and reticuloendothelial neoplasms in children and adolescents between Japan and other countries, we extracted information on cancer incidence in children and adolescents from the third volume of the International Incidence of Childhood Cancer series (IICC-3) (1). The IICC-3 reports the number or incidence rates of cancers occurring in childhood and adolescence, collected from cancer registries (regional or national) worldwide. We analyzed lymphoma and reticuloendothelial neoplasms incidence in four countries in Asia (Japan, China, the Republic of Korea and Thailand), two countries in Africa (Egypt and Uganda), four countries in the Americas [North: the United States of America (USA) and Canada, Latin and Caribbean: Brazil and Colombia], three countries in Europe [the United Kingdom (UK), France and Germany] and two countries in Oceania (Australia and New Zealand). Information from the Republic of Korea, USA, UK, Australia and New Zealand were obtained at the national level, and those from the other countries were from one or multiple regional cancer registries. The years of incidence to be collected varied from country to country, but ranged from 1990 to 2014, with the shortest being 12 years (Egypt: 1999–2010, UK: 2000–2011) and the longest being 24 years (Japan and China: both 1990–2013). In this study, we compared the incidence and proportional distribution of lymphoma subtype in children (0–14 years old) and adolescents (15–19 years old) between these countries. The age-standardized lymphoma and reticuloendothelial neoplasms incidence rates in children (0–14 years old) were the highest in Africa, followed by Latin America. North America, Europe and Oceania had similar levels of incidence, and Asia had lower incidence rates than these regions. In adolescents (15–19 years old), the incidence was higher in North America, Europe and Oceania, followed by Africa and Latin America. The incidence in Asia was low, as in children (Table 1). Incidence rates of lymphoma and reticuloendothelial neoplasms in children and adolescents (per 1 000 000 person-years) aAge-standardized incidence rate. Proportional distribution of subtype of lymphoma and reticuloendothelial neoplasms in children (0–14 years old). Proportional distribution of subtype of lymphoma and reticuloendothelial neoplasms in adolescents (15–19 years old). The subtype distribution of lymphoma and reticuloendothelial neoplasms in children and adolescents varied widely by region in the world. Figure 1 shows the proportional distribution of subtypes of lymphoma and reticuloendothelial neoplasms in children aged 0–14 years by country. In general, the proportion of Hodgkin’s lymphoma in children was about 30–40% in Europe, North America, Latin America and Oceania, whereas it was <20% in Asia and Africa except Egypt. In contrast, the proportion of non-Hodgkin’s lymphoma was slightly lower in Europe and the United States than in Asia and Africa. Burkitt lymphoma tended to be more common in Europe, the United States and Africa, and less common in Asia. Especially in Uganda, more than half of the patients had Burkitt lymphoma. Figure 2 shows the proportional distribution of subtype of lymphoma and reticuloendothelial neoplasms in adolescents aged 15–19 years. In adolescents, the trend seen in children was more pronounced, with Hodgkin’s lymphoma accounting for about 60% of cases in Europe, North America, South America and Oceania, whereas in Asia and Africa except Egypt, the proportion was 20–30%. Non-Hodgkin’s lymphoma was less common in Europe, North America and Oceania, and more common in Asia, Africa and Latin America. There was no large variability in the proportion of Burkitt lymphoma and lymphoreticular lymphoma between countries. Note: Data were extracted from the third volume of the IICC-3 (1). The table and figures are prepared by the authors of this article, and the responsibility for this presentation and its interpretation lies with the authors of this article. None declared.

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