Incidence of non-Hodgkin’s lymphoma among adults in Sardinia, Italy

Abstract

The causes of the peculiar time trend in the incidence of non-Hodgkin’s lymphoma (NHL) in most parts of the world and of its geographic distribution are still unknown. We used the data base of 1974–2003 incident cases of hematological malignancies to explore the time trend of NHL incidence in the region of Sardinia, Italy, and we used Bayesian methods to plot the probability of NHL incidence by residential unit on the regional map. In 1974–2003, 4109 NHL cases were diagnosed among resident adults in Sardinia, with an incidence rate of 13.38 x 10−5 (95% CI 12.97–13.80). NHL incidence showed an upward trend along the study period with an average annual percent change (APC) of 4.94 (95% CI -5.39–16.4), which did not vary by gender or by age-group. Cancer registry data, covering part of the region starting from 1993, suggest that the increasing trend did not persist in the subsequent years. Areas with the highest probability of an excess incidence tended to cluster in the north-eastern part of the region and in two major urban centers, with the low incidence areas located in the south, confirming previous observations. Prevalence of viral infections, environmental and occupational exposures, or socio-economic deprivation would not explain the peculiar geographic distribution we observed. These findings provide convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants of NHL in the risk areas.

COVID-19 and non-Hodgkin’s lymphoma: a common susceptibility pattern?

“…The 1974-2003 NHL age- and gender-adjusted incidence rate among the Sardinian adult population (aged 25 years or more) was 13.4 per 100,000 (95% CI 13.0 – 13.8) [29], ranging from 0 to 27.9 across the 356 communes. The 2020 cumulative incidence of COVID-19 was 2,117 per 100,000 population, ranging from 0 in four communes with 77, 148, 224, and 506 residents, respectively, to 11,935 in a commune with 1,240 residents.…”

“…The age- and gender-standardized incidence rates of NHL between 1974-2003 were available for all the 356 autonomous administrative units (communes) in Sardinia as of 1974 [29]. Briefly, due to the lack of a regional Cancer Registry, the chief haematologist of the Cagliari Oncology Hospital, with the support of the health authorities and the clinical departments of the whole region, created a database of all incident haematological cancers, diagnosed among the Sardinian population of both genders and any age from 1974-2003 [30].…”

“…A recently published Bayesian analysis showed that, over the three decades between 1974 and 2003, the NHL incidence tended to cluster in the north-eastern part of the Italian region of Sardinia and its major urban centre, with the low incidence areas located in the south [29]. The ecological analysis did not identify any plausible explanatory factor among the known conditions associated with an increased NHL risk.…”

COVID-19 and non-Hodgkin’s lymphoma: A common susceptibility pattern?

“…The age-and gender-standardized incidence rates of NHL between 1974-2003 were available for all the 356 autonomous administrative units (communes) in Sardinia as of 1974 [30]. Briefly, due to the lack of a regional Cancer Registry, the chief haematologist of the Cagliari Oncology Hospital, with the support of the health authorities and the clinical departments of the whole region, created and regularly updated a database by prospectively registering all incident haematological cancers diagnosed among the Sardinian population of both genders and any age from 1974-2003 [31].…”

“…A recently published Bayesian analysis showed that, over the three decades between 1974 and 2003, the NHL incidence tended to cluster in the north-eastern part of the Italian region of Sardinia and its major urban centre, with the low incidence areas located in the south [30]. The ecological analysis did not identify plausible explanatory factors among the conditions known to increase NHL risk.…”