Epidemiology of adult and pediatric Burkitt Lymphoma in Canada: Sequelae of the HIV epidemic
Authors: Simon F. Roy, Feras M. Ghazawi, Michelle Le, François Lagacé, Catherine F. Roy, Elham Rahme, Evgeny Savin, Andrei Zubarev, Denis Sasseville, Gizelle Popradi, and Ivan V. Litvinov
Background: Although the pathogenesis and epidemiology of endemic Burkitt lymphoma (BL) has been extensively studied, the epidemiologic landscape of sporadic and immunodeficiency-associated BL in North America remains poorly understood. Methods: We retrospectively studied BL incidence and mortality in Canada using 3 distinct population-based cancer registries. Data on patients’ sex, age at the time of diagnosis, reporting province, city and forward sortation areas (FSA – first three entries of postal codes) were analyzed. Results: In total, 1420 patients with BL were identified in Canada during 1992-2010 (incidence rate 2.40 cases per million patient-years), of which 71.1% were males. The mean age of diagnosis was 55.5±20.8 years. A bimodal incidence by age distribution was seen in both sexes, with pediatric and adult-onset peaks. An analysis based on postal codes (Forward Sortation Areas) identified select communities with statistically higher rates of adult BL. Several of these FSAs were located within the three major metropolitan areas (Montreal, Vancouver and Toronto) and within the self-identified LGBTQ communities. FSAs with a higher socioeconomic status score were associated with lower BL rates. Conclusion: The current results highlight the geographic and historic pattern of BL in Canada. HIV remains an important risk factor for adult BL.
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