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Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017
OBJECTIVE: To determine the global and regional burden of Epstein-Barr virus (EBV)-attributed malignancies. DESIGN: An international comparative study based on the Global Burden of Disease (GBD) Study estimates. SETTING: Global population by age, sex, region, demographic index and time. METHODS AND...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462312/ https://www.ncbi.nlm.nih.gov/pubmed/32868361 http://dx.doi.org/10.1136/bmjopen-2020-037505 |
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author | Khan, Gulfaraz Fitzmaurice, Christina Naghavi, Mohsen Ahmed, Luai A |
author_facet | Khan, Gulfaraz Fitzmaurice, Christina Naghavi, Mohsen Ahmed, Luai A |
author_sort | Khan, Gulfaraz |
collection | PubMed |
description | OBJECTIVE: To determine the global and regional burden of Epstein-Barr virus (EBV)-attributed malignancies. DESIGN: An international comparative study based on the Global Burden of Disease (GBD) Study estimates. SETTING: Global population by age, sex, region, demographic index and time. METHODS AND OUTCOME MEASURES: The burden of EBV-attributed Burkitt lymphoma (BL), Hodgkin lymphoma (HL), nasopharyngeal carcinoma (NPC) and gastric carcinoma (GC) was estimated in a two-step process. In the first step, the fraction of each malignancy attributable to EBV was estimated based on published studies; this was then applied to the GBD estimates to determine the global and regional incidence, mortality and disability-adjusted life-years (DALYs) for each malignancy by age, sex, geographical region and social demographic index (SDI) from 1990 to 2017. RESULTS: The combined global incidence of BL, HL, NPC and GC in 2017 was 1.442 million cases, with over 973 000 deaths. An estimated 265 000 (18%) incident cases and 164 000 (17%) deaths were due to the EBV-attributed fraction. This is an increase of 36% in incidence and 19% in mortality from 1990. In 2017, EBV-attributed malignancies caused 4.604 million DALYs, of which 82% was due to NPC and GC alone. The incidence of both of these malignancies was higher in high and middle-high SDI regions and peaked in adults aged between 50 and 70 years. All four malignancies were more common in males and the highest burden was observed in East Asia. CONCLUSIONS: This study provides comprehensive estimates of the burden of EBV-attributed BL, HL, NPC and GC. The overall burden of EBV-related malignancies is likely to be higher since EBV is aetiologically linked to several other malignancies not included in this analysis. Increasing global population and life expectancy is expected to further raise this burden in the future. The urgency for developing an effective vaccine to prevent these malignancies cannot be overstated. |
format | Online Article Text |
id | pubmed-7462312 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-74623122020-09-11 Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 Khan, Gulfaraz Fitzmaurice, Christina Naghavi, Mohsen Ahmed, Luai A BMJ Open Public Health OBJECTIVE: To determine the global and regional burden of Epstein-Barr virus (EBV)-attributed malignancies. DESIGN: An international comparative study based on the Global Burden of Disease (GBD) Study estimates. SETTING: Global population by age, sex, region, demographic index and time. METHODS AND OUTCOME MEASURES: The burden of EBV-attributed Burkitt lymphoma (BL), Hodgkin lymphoma (HL), nasopharyngeal carcinoma (NPC) and gastric carcinoma (GC) was estimated in a two-step process. In the first step, the fraction of each malignancy attributable to EBV was estimated based on published studies; this was then applied to the GBD estimates to determine the global and regional incidence, mortality and disability-adjusted life-years (DALYs) for each malignancy by age, sex, geographical region and social demographic index (SDI) from 1990 to 2017. RESULTS: The combined global incidence of BL, HL, NPC and GC in 2017 was 1.442 million cases, with over 973 000 deaths. An estimated 265 000 (18%) incident cases and 164 000 (17%) deaths were due to the EBV-attributed fraction. This is an increase of 36% in incidence and 19% in mortality from 1990. In 2017, EBV-attributed malignancies caused 4.604 million DALYs, of which 82% was due to NPC and GC alone. The incidence of both of these malignancies was higher in high and middle-high SDI regions and peaked in adults aged between 50 and 70 years. All four malignancies were more common in males and the highest burden was observed in East Asia. CONCLUSIONS: This study provides comprehensive estimates of the burden of EBV-attributed BL, HL, NPC and GC. The overall burden of EBV-related malignancies is likely to be higher since EBV is aetiologically linked to several other malignancies not included in this analysis. Increasing global population and life expectancy is expected to further raise this burden in the future. The urgency for developing an effective vaccine to prevent these malignancies cannot be overstated. BMJ Publishing Group 2020-08-30 /pmc/articles/PMC7462312/ /pubmed/32868361 http://dx.doi.org/10.1136/bmjopen-2020-037505 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Public Health Khan, Gulfaraz Fitzmaurice, Christina Naghavi, Mohsen Ahmed, Luai A Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title | Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title_full | Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title_fullStr | Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title_full_unstemmed | Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title_short | Global and regional incidence, mortality and disability-adjusted life-years for Epstein-Barr virus-attributable malignancies, 1990–2017 |
title_sort | global and regional incidence, mortality and disability-adjusted life-years for epstein-barr virus-attributable malignancies, 1990–2017 |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462312/ https://www.ncbi.nlm.nih.gov/pubmed/32868361 http://dx.doi.org/10.1136/bmjopen-2020-037505 |
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