Burden of Middle-Aged and Elderly Patients With Non-Hodgkin Lymphoma From 1990 to 2021: A Systematic Analysis Based on the Global Burden of Disease 2021.

[BACKGROUND] Non-Hodgkin lymphoma (NHL) is increasingly prevalent in middle-aged and elderly populations, contributing to the rising global health burden, particularly in high-income countries.

[METHODS] This retrospective analysis utilized data from the Global Burden of Disease (GBD) study (1990-2021) to examine temporal trends in age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates of NHL among middle-aged and older adult populations, incorporating age- and sex-stratified comparisons. Furthermore, projections for the subsequent 30 years were generated using Bayesian age-period-cohort (BAPC) modeling.

[RESULTS] From 1990 to 2021, the number of cases, deaths, and DALYs in middle-aged and older people with NHL had significant increases. Age-standardized incidence rates exhibited an increasing trend (estimated annual percentage change [EAPC] = 0.53), whereas mortality (EAPC = -0.33) and DALY rates (EAPC = -0.52) demonstrated a decreasing trend. The Western European region and high SDI countries are the core burden areas for middle-aged and elderly populations with NHL globally. Lower-middle SDI countries experienced the fastest increase in mortality (EAPC = 0.38) and DALY rates (EAPC = 0.22), while high-SDI countries experienced the steepest decline in all metrics. The DALY burden showed its peak value at 65-69 years among middle-aged and aged adults with NHL, while the morbidity and mortality burden reached their highest point at 70-74 years. When stratified by gender, the overall burden was higher in males than in females. High BMI causes the burden of NHL DALY to rise with increasing SDI, up to 39.14% in High-income North America. By 2050, global NHL incidence is projected to increase modestly by 0.28%, whereas mortality and DALY burdens are expected to decline markedly by 30.67% and 23.02%, respectively.

[CONCLUSIONS] NHL in middle-aged and older adults represents a significant global public health burden, necessitating context-specific interventions due to variations across regions, genders, and age groups.