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This research examines mortality differences in Hodgkin lymphoma among adolescents and young adults by race/ethnicity and geography from 1999 to 2023.

May 30, 2026

Racial and geographic disparities in Hodgkin lymphoma mortality among adolescents and young adults in the United States, 1999-2023.

Key Points

This research examines mortality differences in Hodgkin lymphoma among adolescents and young adults by race/ethnicity and geography from 1999 to 2023.
Utilized CDC WONDER databases (1999-2023) to identify deaths from Hodgkin lymphoma in individuals aged 15-44
Reported age-adjusted mortality rates (AARs) for NH White, NH Black, and Hispanic AYAs by study period
Descriptively summarized regional/state patterns based on age-adjusted mortality rates.
Mortality rates declined across all groups from 1999-2023, with NH White AYAs seeing an ≈80% decline compared to ≈56% for NH Black AYAs.
Age-adjusted mortality rate (AAR) for NH Black AYAs dropped from 0.399 (1999-2005) to 0.174 (2021-2023) while NH White AYAs dropped from 0.337 to 0.068.
Significant regional variations were found, with NH Black AYAs consistently exhibiting higher mortality rates than NH White AYAs in multiple states.

Abstract

e13738 Background: Hodgkin lymphoma (HL) in adolescents and young adults (AYAs) is highly curable, and population-level mortality is low. In a highly curable condition, mortality gaps by race/ethnicity may reflect inequities in access to timely diagnosis and curative therapy. We hypothesized that HL mortality would differ by race/ethnicity and vary geographically over time. Prior studies have demonstrated racial and socioeconomic disparities in AYA HL survival, but national and state-level patterns in AYA HL mortality using death certificate-based data remain less well characterized. Methods: We used the CDC WONDER Multiple Cause of Death databases (1999-2020 and 2018-2023) to identify deaths from HL as the underlying cause (ICD-10 C81) among individuals aged 15-44 years, combining 1999-2020 with 2021-2023 to avoid duplicate years. Using CDC WONDER race/ethnicity categories, we report non-Hispanic (NH) White, NH Black, and Hispanic AYAs. We extracted age-adjusted mortality rates (AARs) per 100,000 with 95% confidence intervals (CIs) for 1999-2005, 2006-2012, 2013-2020, and 2021-2023 and summarized regional/state patterns descriptively. Results: HL mortality declined from 1999 to 2023 across all groups, with a larger decline among NH White AYAs (≈80%) than NH Black AYAs (≈56%). In 1999-2005, AAR was 0.399 (CI 0.361-0.436) for NH Black AYAs, 0.337 (CI 0.321-0.352) for NH White AYAs, and 0.168 (CI 0.145-0.192) for Hispanic AYAs. In 2021-2023, AAR was 0.174 (CI 0.138-0.216), 0.068 (CI 0.058-0.079), and 0.068 (CI 0.050-0.091), respectively. Across periods, NH Black AYAs consistently had higher mortality than NH White AYAs, with the largest absolute difference in 2021-2023 (0.106 per 100,000). State-level estimates varied. In states with adequate deaths to estimate stable rates, NH Black AARs exceeded NH White in TN, GA, MS, MD, IL, TX, VA, and MI, with smaller differences in CA, NY, FL, NC, SC, PA, AL, and LA. Conclusions: HL mortality among US AYAs has declined substantially from 1999-2023, yet race/ethnicity differences persist and vary geographically. In a highly curable malignancy, these gaps underscore the need to strengthen equitable access to timely diagnosis and guideline-concordant curative therapy. National age-adjusted HL mortality among AYAs (15-44 years) by period and race/ethnicity. Era Non-Hispanic Black AAR (95% CI) Non-Hispanic White AAR (95% CI) Hispanic AAR (95% CI) Absolute Difference (Non-Hispanic Black - Non-Hispanic White) 1999-2005 0.399 (0.361-0.436) 0.337 (0.321-0.352) 0.168 (0.145-0.192) 0.062 2006-2012 0.305 (0.272-0.338) 0.237 (0.224-0.249) 0.168 (0.148-0.188) 0.068 2013-2020 0.168 (0.147-0.190) 0.100 (0.092-0.108) 0.168 (0.148-0.188) 0.068 2021-2023 0.174 (0.138-0.216) 0.068 (0.058-0.079) 0.068 (0.050-0.091) 0.106 AAR = age-adjusted mortality rate per 100,000; CI = confidence interval.

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