Projecting non Hodgkin lymphoma mortality for young adults in the United States(2024-2040):a national population-based modeling study

Abstract Background: Non-Hodgkin lymphoma (NHL) represents a significant cancer burden in young adults. While survival rates have improved in recent decades,the literature highlights the persistent disparities in mortality rates (between various demographic variables).The long term trajectory and evolution of these disparities have been insufficiently characterised.This study utilizes comprehensive nationally representative data to forecast the trends in NHL age adjusted mortality rates(AAMR) in young adults through 2040,with a particular focus on evolving disparities. Methods: Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research(CDC WONDER) was surveyed between 1999 to 2023 using ICD 10 codes(C82.0, C82.1 ,C82.3 ,C82.7, C82.9, C83.0, C83.1, C83.2, C83.4, C83.5, C82.6, C82.7, C82.8, C82.9, C85.0, C85.1, C85.7, C85.9) to find the AAMR for NHL in individuals between the ages of 15-45.The data was further stratified into sub groups; sex, race(White/Black) and geography(metropolitan/non-metropolitan).An ARIMA(Autoregressive Integrated Moving Average) model ,using Python 3, was constructed and utilized to forecast trends through 2040 (with 95% CIs) using the 1999 to 2023 data. Results: Non-Hodgkin Lymphoma AAMRs for young adults are projected to stabilize between 0.49 to 0.56 per 100,000 people between 2024 to 2040. Gender disparity is expected to increase from 2.1 fold in 2024 to 4.5 fold in 2040. Male mortality rates show an increase from 0.62 to 0.76(+22.6%) between 2024 and 2040, while female rates demonstrate a decline from 0.30 to 0.17(-43.3%).Racial disparities show modest improvement, with Black populations experiencing a reduction from 0.66 to 0.63(-4.5%) compared to a more pronounced decline in White populations (from 0.42 to 0.36; -14.3%).This is projected to narrow the racial mortality rate gap from 0.24 in 2024 to 0.21 points in 2040(-12.5%). Geographic analyses reveal both metro and non-metro areas achieving significant reductions, with metro areas declining 45.7% (0.35 to 0.19) and non-metro areas showing an even greater 51.8% decrease (0.56 to 0.27).The absolute gap shrinks from 0.21 points to 0.08 points(-62%). Conclusion: Projected NHL mortality trends reveal encouraging decrease in disparities between racial and geographic sub groups. However,the gender gap is forecasted to increase which underscores the importance of targeted interventions and policies to rectify these inequalities in time.