Table 4_Global, regional, and national epidemiology of childhood Burkitt Lymphoma from 1990 to 2021: statistical analysis of incidence, mortality, and DALYs.docx

ObjectiveEpidemiological data concerning Burkitt Lymphoma (BL) in children aged 0–14 years remain limited. This study examines the trends in incidence, mortality, and disability-adjusted life years (DALYs), as well as the estimated annual percentage change (EAPC) associated with childhood Burkitt Lymphoma within this demographic from 1990 to 2021.
MethodsThe 2021 Global Burden of Disease, Injuries, and Risk Factors Study (GBD) analytical tools were utilized to evaluate the incidence, mortality, and disability-adjusted life years (DALYs) associated with childhood Burkitt Lymphoma in individuals aged 0–14 years. This analysis incorporated variables such as age, sex, region, and sociodemographic index (SDI), utilizing data from 204 countries or regions. A comprehensive examination of health disparities was undertaken to investigate variations in mortality and DALYs among different population groups. Additionally, the Bayesian age-period-cohort (BAPC) model was employed to forecast incidence, mortality, and DALYs through the year 2035.
ResultsIn 2021, a total of 4,083 cases of childhood Burkitt Lymphoma were documented globally. This represents an increase from 2,800 cases reported in 1990, with a 95% uncertainty interval (UI) ranging from 1,609.001 to 3,989.282, to 4,083 cases in 2021 (95% UI, 2,619.594 to 5,376.872), indicating a 31.45% rise over the period. During this 30-year span, the global incidence rate escalated from 0.172 per 100,000 individuals in 1990 (95% UI, 0.099 to 0.245) to 0.216 per 100,000 individuals in 2021 (95% UI, 0.138 to 0.285). Concurrently, the mortality rate associated with childhood Burkitt Lymphoma increased from 0.152 per 100,000 individuals in 1990 (95% UI, 0.079 to 0.224) to 0.163 per 100,000 individuals in 2021 (95% UI, 0.100 to 0.216). The highest incidence in 2021 was recorded in Sub-Saharan East Africa, while Sub-Saharan Southern Africa experienced the most pronounced increase in incidence, with an annual percent change (APC) of 3.226% (95% confidence interval [CI]: 2.092–4.373%). The age group most affected was children aged 5–9 years, who constituted 33.3% of the cases.
ConclusionBetween 1990 and 2021, there was a notable rise in the incidence of childhood Burkitt Lymphoma, with a pronounced increase observed in Sub-Saharan Africa. The age group of 5–9 years exhibited the highest incidence and mortality rates, underscoring the critical need for early diagnosis and intervention. Although regions with high Socio-Demographic Index (SDI) have demonstrated advancements in reducing mortality rates, areas with low SDI necessitate improved medical resources and the implementation of standardized treatment protocols. The escalating incidence in specific regions underscores the urgent need for comprehensive research into the disease’s etiology and the development of enhanced prevention strategies.

研究目的
目前针对0~14岁儿童伯基特淋巴瘤（Burkitt Lymphoma, BL）的流行病学数据仍较为匮乏。本研究旨在分析1990年至2021年间，该人群儿童伯基特淋巴瘤的发病率、死亡率、伤残调整生命年（disability-adjusted life years, DALYs）以及相关估计年度百分比变化（estimated annual percentage change, EAPC）的变化趋势。
研究方法
本研究采用2021年全球疾病、伤害和危险因素负担研究（Global Burden of Disease, Injuries, and Risk Factors Study, GBD）的分析工具，对0~14岁儿童伯基特淋巴瘤的发病率、死亡率及伤残调整生命年进行评估。本分析纳入了年龄、性别、地区及社会人口学指数（sociodemographic index, SDI）等变量，数据来源于204个国家或地区。研究同时开展了健康公平性的全面分析，以探究不同人群组间死亡率与伤残调整生命年的差异。此外，本研究采用贝叶斯年龄-时期-队列（Bayesian age-period-cohort, BAPC）模型，对2035年之前的发病率、死亡率及伤残调整生命年进行预测。
研究结果
2021年，全球共报告儿童伯基特淋巴瘤病例4083例。相较于1990年报告的2800例，该数据较研究周期内增长了31.45%；1990年的95%不确定性区间（uncertainty interval, UI）为1609.001~3989.282，2021年的95% UI为2619.594~5376.872。在这30年间，全球儿童伯基特淋巴瘤发病率从1990年的0.172/10万（95% UI：0.099~0.245）升至2021年的0.216/10万（95% UI：0.138~0.285）。与此同时，儿童伯基特淋巴瘤死亡率也从1990年的0.152/10万（95% UI：0.079~0.224）升至2021年的0.163/10万（95% UI：0.100~0.216）。2021年，撒哈拉以南东非地区的发病率最高，而撒哈拉以南南非地区的发病率增幅最为显著，年度百分比变化（annual percent change, APC）为3.226%（95%置信区间[CI]：2.092~4.373%）。受影响最严重的年龄组为5~9岁儿童，该组病例占总病例数的33.3%。
研究结论
1990年至2021年间，儿童伯基特淋巴瘤的发病率显著上升，其中撒哈拉以南非洲地区的增幅尤为明显。5~9岁儿童的发病率与死亡率均为最高，这凸显了早期诊断与干预的迫切必要性。尽管高社会人口学指数（SDI）地区在降低死亡率方面已取得进展，但低SDI地区仍需优化医疗资源配置并推广标准化治疗方案。特定地区发病率的持续攀升，也突显了针对该疾病病因开展全面研究以及制定更完善预防策略的紧迫性。