Epidemiological Overview of Hodgkin Lymphoma Across the Mediterranean Basin

Abstract

The epidemiology of Hodgkin lymphoma (HL) has always been a source of fascination to researchers due to its heterogeneous characteristics of presentation. HL is an uncommon neoplasm of B-cell origin with an incidence that varies significantly by age, sex, ethnicity, geographic location and socioeconomic status. This complex pattern was also found to be replicated among Mediterranean basin populations. HL incidence rates progressively decreased from industrialized European countries such as France (ASR=2.61) and Italy (ASR=2.39) to less developed nations such as Albania (ASR=1.34) and Bosnia Herzegovina (ASR=1.1). Regarding HL mortality we have found that countries with the lowest incidence rates show the highest number of deaths from this cancer and viceversa. Finally, a wide gap in terms of survival was showed across the Mediterranean basin with survival rates ranged from 82.3% and 85.1% among Italian men and women, to 53.3 % and 59.3% among Libyan men and women, respectively. Factors such as the degree of socio-economic development, the exposure to risk factors westernization-related, the availability of diagnostic practices along with different genetic susceptibilities to HL may explain its variation across Mediterranean countries. Furthermore, the lack of health resources decisively contribute to the poor prognosis recorded in less developed region. In the future, the introduction of appropriate and accessible treatment facilities along with an adequate number of clinical specialists in the treatment of HL and other cancers are warranted in order to improve the outcomes of affected patients and treat a largely curable type of cancer in disadvantaged regions.

Distribution of lymphomas in Mexico: a multicenter descriptive study

“…This pattern of predominance, where classical HL conforms the majority and nodular lymphocyte predominant conforms only a minority and usually less than 10% of all HL, is . The distribution of HL in Mexico followed the usual pattern reported in other series in North America [32][33][34][35].…”

Alcohol consumption and risk of hematological malignancies: A meta‐analysis of prospective studies

“…Non‐Hodgkin lymphoma (NHL) has been strongly associated with infectious agents like viruses (HIV, EBV, HTLV‐1), bacteria ( Helicobacter pylori ), immune deficiency, autoimmune disorders and the use of antineoplastic drugs . Hodgkin lymphoma (HL) incidence seems to vary significantly in relation with ethnicity and socio‐economic status . As far as lifestyle factors are concerned, there are studies supporting a positive correlation between the risk of various subtypes of lymphomas and smoking, BMI and exposure to pesticides; however, physical activity and UV exposure may protect against lymphomas .…”

Incidence of Childhood Hodgkin Lymphoma in Mexico by Histologic Subtypes and Socioeconomic Regions

“…[5][6][7] These subtypes also have been shown to have distinct clinical, epidemiological, and socioeconomic characteristics in their presentation. [8][9][10] In developing countries, where HL seems to have a higher incidence, HL often is presented at earlier ages and with a predominance of the MC histologic subtype. 11,12 This subtype predominates in males (male:female, 3:1), has a high association with infection by Epstein-Barr virus (EBV)-approximately 90% of HL tumors are positive for EBV antigens, 8,13 and has a more unfavorable prognosis.…”