Incidence and trends in Burkitt lymphoma in northern Tanzania from 2000 to 2009

Abstract

Introduction Burkitt lymphoma (BL) is endemic in parts of Tanzania, but there is scant country or region level data about burden and trends of BL in Tanzania over the past three decades. Here, we update baseline epidemiology of BL in northern Tanzania using recent data. Procedure Data for childhood BL diagnosed at six hospitals in Mara and Mwanza regions in northern Tanzania during 2000 – 2009 were compiled. Age, sex, and regional patterns were analyzed. Crude incidence rates of BL were calculated by sex, anatomic site, geographical region, and calendar year. Results Among 944 cases, 549 (58%) were male (male/female case ratio 1.4:1). Among those with known anatomic site (92%), facial only tumors represented a large proportion of tumors in boys than girls (50% versus 36%, P<0.002). Tumors occurred at a younger mean age in boys than girls (6.8 versus 7.6 years, P<0.01). Crude BL incidence was 4.2 per 100,000, but varied by region (3.0 in Mwanza versus 6.8 in Mara, P=0.01), by district (from 1.4 to 22), by gender (5.0 in boys versus 4.0 in girls) and by age group (2.0 in 0–4, 7.8 in 5–9, and 3.1 in 10–15 years). BL incidence peaked in 2001 and decreased gradually thereafter. Conclusions Our results indicate that male sex, young age, and geographical characteristics are risk factors for BL in Tanzania. BL incidence declined with calendar year, but the significance of this finding is uncertain. Well-designed epidemiological studies of BL in Tanzania may shed light on environmental characteristics underlying these patterns.

Cancer in Africa 2012

“…It is not clear why ART appears to have been less successful in reducing incidence of NHL compared with that of KS (above), although as noted, the risk associated with HIV infection is much lower for NHL than for KS, and poor coverage, late commencement of ART, and incomplete viral suppression may mask any effect at population level. In neither Harare nor Kampala has there been much change in incidence of BL, although a recent decline in incidence has been reported in northern Tanzania (42). Lung cancer.…”

Burkitt lymphoma in adolescents and young adults: management challenges

“…In a study from Uganda (n=1088), median patient age was 7 years, and apparently, no case was older than 14 years 110. Comparable data were provided by another large study from Northern Tanzania (n=944) and by a collaborative series from equatorial Africa (n=356),111,112 in which only 13 patients (3.7%) were aged ≥15 years. Apart from this uniqueness, delayed referral to treatment center, favoring growth and dissemination of BL,113 low socioeconomic status of patient families, and serious economic constraints of health systems all preclude access to expensive drugs (rituximab, high-dose therapies) and high-level supportive care, excluding these patients from the most effective, modern chemoimmunotherapy regimens.…”

Incidence of Endemic Burkitt Lymphoma in Three Regions of Mozambique

“…12 Distribution by sex, age, and anatomical location of eBL in Mozambique are in line with the published literature. 3,4,17,18 Incidence of eBL between 2010 and 2014 ranged between 2.2 in 2011 to 3.0 per 10 6 pyar in 2015. The higher incidence observed in 2015 can be potentially explained by the active detection of cases.…”

“…18 Reported crude incidence rate in Uganda is lower (1.8 per 10 6 pyar), 19 whereas in Tanzania is higher (i.e., 4.2 per 10 6 pyar). 17 Information on population-based incidence of eBL in other African countries is scarce but several reports indicate that eBL is the most common childhood cancer in several African settings.…”