Hodgkin's lymphoma mortality in the Americas, 1997–2008: Achievements and persistent inadequacies

Abstract

Although therapeutic advancements have made Hodgkin's lymphoma (HL) a largely curable disease, trends in HL mortality have been variable across countries. To provide updated information on HL mortality in the Americas, overall and 20–44 years age‐standardized (world population) mortality rates from HL were derived for the 12 Latin American countries providing valid data to the World Health Organization database and with more than two million of inhabitants. For comparative purpose, data for the United States and Canada were also presented. Trends in mortality over the 1997 to 2008 period are based on joinpoint regression analysis. Declines in HL mortality were registered in all Latin American countries except in Venezuela. In most recent years, HL mortality had fallen to about 0.3/100,000 men and 0.2/100,000 women in Argentina, Brazil, Chile, Colombia, Ecuador and Guatemala, that is, to values similar to North America. Despite some declines, rates remained high in Cuba (1/100,000 men and 0.7/100,000 women), Costa Rica and Mexico as well as in Venezuela (between 0.5 and 0.6/100,000 men and between 0.3 and 0.5/100,000 women). In young adults, trends were more favorable in all Latin American countries except Cuba, whose rates remained exceedingly high (0.8/100,000 men and 0.6/100,000 women). Thus, appreciable declines in HL mortality were observed in most Latin America over the last decade, and several major countries reached values comparable to North America. Substantial excess mortality was still observed in Cuba, Costa Rica, Mexico and Venezuela, calling for urgent interventions to improve HL management in these countries.

Treatment outcomes for Hodgkin lymphoma: First report from the Brazilian Prospective Registry

“…Randomized clinical trials conducted by cooperative groups in North America and Europe have identified treatment schedules that provide higher efficacy and lower toxicity. However, data about HL in developing countries are scarce and come mostly from retrospective series . These data suggest that there are substantial disparities in healthcare and treatment outcomes for HL patients in large areas of the world.…”

Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients—An analysis from the Brazilian Hodgkin Lymphoma Registry

“…The outcome of Hodgkin's lymphoma (HL) has markedly improved over the past few decades, making HL one of the cancers with the greatest chances of cure . However, data about HL in developing countries are limited and come mostly from retrospective series . These data suggest the existence of substantial disparities in health care and treatment outcomes for HL patients in large areas of the world.…”

“…1 However, data about HL in developing countries are limited and come mostly from retrospective series. [2][3][4][5][6] These data suggest the existence of substantial disparities in health care and treatment outcomes for HL patients in large areas of the world.…”

Cancer Control in Central and Eastern Europe

“…Furthermore, mortality from several cancers highly curable with medical therapies including testicular cancer [7, 13], Hodgkin’s lymphomas [6, 7] and leukemias [10, 14] remains higher in Central and Eastern Europe compared with Western Europe [7], but also compared with North America and selected major countries of South America, including Brazil and Argentina [15]. Likewise, although some decline in breast cancer mortality—another neoplasm largely amendable to cure—has been observed in recent years in Central and Eastern Europe [16], this decline has been smaller than that in Western Europe.…”

“…An increase in cancer control expenditure would most likely have a favorable effect on cancer mortality in Central and Eastern Europe. However, it is now clear that countries such as Brazil and Argentina, with gross national per capita products comparable to or, in some instances, lower than those in several Central and Eastern European countries, have achieved a better management in highly treatable cancers, such as Hodgkin’s lymphoma [15] than that achieved by several countries in Central and Eastern Europe. Besides expenditure, therefore, several measures aimed at improving clinical management (addressing gaps in specialty training and facilities from pathological diagnosis to multidisciplinary treatments), and optimizing cancer control (such as antismoking measures), as outlined by Vrdoljak et al [2], are required to reduce cancer rates in Central and Eastern Europe to levels comparable with those in other high-income countries.…”