# 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

## TL;DR

Non-Hodgkin lymphoma in middle-aged and elderly people has increased globally, but mortality and disability are expected to decline by 2050.

## Contribution

This study provides a global analysis of NHL trends in middle-aged and elderly populations using GBD data and BAPC modeling.

## Key findings

- NHL incidence increased from 1990 to 2021, but mortality and DALY rates decreased.
- High SDI countries saw the steepest decline in NHL burden, while lower-middle SDI countries experienced the fastest increase.
- Males had a higher NHL burden than females, and the highest DALY burden occurred at 65–69 years.

## Abstract

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.

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.

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.

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.