Temporal trends in the incidence of Hodgkin's lymphoma in the Middle East and North Africa over the past three decades.

Abstract

Background: Hodgkin lymphoma (HL) is a rare yet important hematologic malignancy of B-cell origin. While global incidence rates vary, the epidemiology of HL in the Middle East and North Africa (MENA) is not well understood due to limited regional data. This study uses Global Burden of Disease (GBD) data to analyze HL incidence trends in MENA over the past three decades, aiming to shed light on the evolving burden of the disease in this region. Methods: Data on age-standardized incidence rates (ASIR) for HL in the MENA from 1990 to 2019 were collected from the GBD database. Joinpoint regression software was utilized to calculate the annual percent change (APC) and average annual percent change (AAPC) in ASIR, with stratification by country. Results: From 1990 to 2019, an estimated total of 94,221 cases of HL were reported in the MENA, with 58.2% of cases in males. A statistically significant increase in ASIR was observed across the region, with an AAPC of 0.40 (95% CI 0.37 to 0.43, p<0.001). Significant increases in ASIR were observed in Algeria, Bahrain, Iran, Jordan, Libya, Oman, Qatar, Saudi Arabia, Syria, and Tunisia, with the most prominent rise in Iran (AAPC 2.84). In contrast, Afghanistan, Iraq, Morocco, Palestinian Territories, Sudan, Turkey, and Yemen experienced significant declines in ASIR, with the steepest decrease seen in Morocco (AAPC -0.27). No significant changes were observed in Egypt and the United Arab Emirates. Conclusions: Our analysis shows a significant increase in HL incidence across the MENA from 1990 to 2019. The rise was especially noted in Iran, Saudi Arabia, and Tunisia. This increase could reflect improved early detection, better reporting systems, and changes in environmental or lifestyle factors. However, Morocco, Yemen, and Iraq saw declines, while Egypt and the UAE showed no significant changes. The varying trends reflect the complex, often bimodal patterns seen globally, likely driven by a combination of better healthcare access, epidemiological shifts, and environmental influences. These findings emphasize the need for region-specific healthcare strategies to address the growing HL burden in the MENA.