The national and subnational burden of Non-Hodgkin Lymphomas (NHL) in Italy from 1990 to 2023: results from the Global Burden of Disease Study 2023.
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BACKGROUND: Non-Hodgkin Lymphomas (NHL) are a large group of 70 different oncohematological malignancies. This study investigated the global burden of NHL and its temporal trends from 1990 to 2023, at the Italian national and subnational level (21 regions/provinces). METHODS: We used the Global Burden of Disease Study 2023 estimates to describe the NHL age-standardized incidence (ASIR), mortality (ASMR), years lived with disability (ASYLD), years of life lost (ASYLL), disability-adjusted life years (ASDR) rates, the related 1990-2023 crude all-ages and age-standardized annual rate of changes (ARC), as well as the age-standardized mortality-to-incidence ratio (MIR). Finally, the national estimates for NHL were compared to those for the GBD Global and High-middle Socio-Demographic Index (SDI) countries. FINDINGS: In 2023 at the Italian national level, there were 19,000 NHL new cases, 6020 deaths and 118,120 DALYs, whose majority came from YLLs (92.3%). The 1990-2023 ARC for ASIR was stable, overall (0.20; 95% uncertainty interval (UI) -0.34 to 1.06) as well as among females and males. Both the ARC for ASMR (-0.21; -0.34 to -0.07) and ASDR (-0.33; -0.44 to -0.22) declined over time. The MIR notably improved, reducing from 34.3 to 22.8. At the subnational level, the ASIR was stable in all 21 regions, while the ASMR and ASDR showed a significant decline in 12 and 19 regions, respectively. INTERPRETATION: The age-standardized deaths and DALYs rates due to NHL significantly decreased over time in Italy, while the incidence rate was stable. Increased early detection, new therapeutic regimens availability and risk factors pattern modification might justify these findings. Comparing the national estimates to those for the High-middle SDI region, the ARC for incidence, mortality, YLLs and DALYs showed a larger improvement. Italian subnational estimates were in good agreement with the national data, with some geographical differences. FUNDING: This work was supported by the Italian Ministry of Health, through the contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste - Italy.