Comparing Hodgkin and Non-Hodgkin Lymphoma Mortality Between Latin America and the United States From 2008 to 2019: The Need of Regional-Based Lymphoma Registries.

Abstract

Purpose: Population-based registries are essential for evaluating disease patterns, but whether the existing surveillance systems are helpful in monitoring lymphoma mortality outcomes in Latin America is unknown. To explore the utility and identify gaps in existing registries, we compared Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) mortality in Latin American countries with that in the United States.

Methods: We conducted a population-based descriptive study using mortality data from the WHO for 16 Latin American countries and the National Center for Health Statistics for the United States. All deaths occurring among adults 20 years and older (2008-2019 period) were extracted from death certificates. We compared mortality with that of US non-Hispanic White (US White) individuals by fitting Poisson models.

Results: In overall analyses, we observed higher HL mortality compared with US White individuals across several Latin American countries (mortality rate ratio [MRR] range, 1.25-2.96), particularly in Cuba (MRR, 2.96; 95% CI, 2.80 to 3.13). Although we observed lower NHL mortality in all Latin American countries compared with US White individuals in the overall analysis, age-stratified models showed higher mortality among young adults (20-39 years) in most countries (MRRs range, 1.36-2.52), notably in Cuba (MRR, 2.52; 95% CI, 2.26 to 2.80; P_{heterogeneity} < .0001). Patterns by sex were similar to the overall analysis. We identified a high proportion (>95%) of unspecified lymphoma mortality.

Conclusion: Although we identified significant mortality differences between Latin American countries and the United States, the heterogeneity in age-stratified models and high percentage of unspecified lymphomas may reflect the limitations of death certification for monitoring mortality outcomes of recognized lymphoma subtypes. Our findings highlight the unmet need for a lymphoma-focused registry in Latin America.