The burden of Burkitt lymphoma in Africa

Abstract

Background Burkitt lymphoma (BL) is a relatively common cancer of childhood in tropical Africa, although its precise incidence and continent-wide geographic distribution have not been previously systematically studied. Methods Using the methods employed to produce national estimates of cancer incidence for the “Globocan” series of the International Agency for Research on Cancer, along with detailed information on cancer incidence by histological subtype from cancer registries in Africa, we estimate the numbers and rates of incidence by sex, age group, country and region of Africa. Results We estimate that the number of new cases that occurred in 2018 to be about 3900, two thirds in males, and 81% in children aged 0–14. On a national basis, the geographic distribution of incidence rates among children in sub-Saharan Africa resembles that of the prevalence of infection with Falciparum malaria. An estimated 81% of cases are associated with infection with Epstein Barr virus (EBV). Conclusions BL comprises almost 50% of childhood of non-Hodgkin lymphoma in Africa, almost all of which are associated with EBV, with the geographic distribution – at least in sub Saharan Africa - mediated by infection with malaria.

Endemic Burkitt lymphoma: a complication of asymptomatic malaria in sub-Saharan Africa based on published literature and primary data from Uganda, Tanzania, and Kenya

“…Endemic Burkitt Lymphoma (eBL) is an aggressive B-cell non-Hodgkin lymphoma that is associated with endemic Plasmodium falciparum malaria [ 1 ]. Thus, the incidence of eBL correlates with the endemicity of P. falciparum malaria [ 1 – 3 ] and eBL incidence is highest in malaria endemic countries in sub-Saharan Africa [ 4 ], where eBL cases account for 50–75% of childhood cancers in some countries [ 5 ]. The role of malaria is supported by significant associations of eBL risk with high antibody titers of markers of long-term exposure to P. falciparum infection [ 6 – 8 ] and inverse associations with antibodies that are associated with protection from severe P. falciparum infection [ 6 , 9 ].…”

Relative Frequencies and Patterns of Malignant Lymphoma in a Reference Centre in Khartoum, Sudan: A Descriptive Study Based on the WHO Classification of Lymphoid Neoplasms

“…In Pakistan 66.1% of NHL cases were reported to be of DLBCL subtype [21]. In some African countries the distribution of NHL subtypes varies according to age group, with DLBCL accounting for 55% of all NHL cases among adults, [22] and BL comprising nearly 50% of childhood cases of NHL in Africa [23]. Regarding HL, mixed cellularity, was the more predominated type in the present study.…”

Cancer in Africa 2018: The role of infections

“…We used data from the African cancer registries contributing to Globocan, and the same methods to make national and regional estimates for squamous cell carcinoma of conjunctiva (SCCC), Burkitt lymphoma (BL), primary gastric lymphomas (PGL) and noncardia gastric cancers (NCGC). The methods used to estimate the former two cancers will be published elsewhere . In summary, they are based on the age‐/sex‐specific proportions of cancers of the eye that were squamous cell carcinomas, or unspecified cancers of the conjunctiva, and of NHL that were BL (ICD‐O M9687/3).…”

“…The methods used to estimate the former two cancers will be published elsewhere. 9,10 In summary, they are based on the age-/sex-specific proportions of cancers of the eye that were squamous cell carcinomas, or unspecified cancers of the conjunctiva, and of NHL that were BL (ICD-O M9687/3). PGL was estimated for each contributing registry as the proportion (by age and sex) of NHL located in stomach (C16.x) plus 1/3 of NHL cases recorded as being in the "Abdomen" (C76.2).…”