Leukemia Incidence and Demographic Trends in Saudi Arabia, 1997-2022: A Nationwide Registry Analysis

Leukemia presents a significant and evolving public health challenge in Saudi Arabia, yet long-term nationwide epidemiological trends are unavailable. This study aimed to characterize temporal, demographic, and regional patterns in leukemia incidence from 1997 to 2022.

We conducted a retrospective nationwide analysis using the Saudi Cancer Registry and Global Burden of Disease data. We calculated age-standardized incidence rates (ASR), age-specific incidence rates (AIR) per 100 000, and average/annual percentage changes (AAPC/APC) by age, sex, leukemia type, and administrative region.

The overall ASR was 5.9, with an increase over time (AAPC = 2.28, 95% CI 1.68‒2.87), sharply accelerating after 2016 (APC = 9.47, 95% CI 6.21‒15.18). This trend was driven by a dual burden in pediatric (0-14 years; boys AAPC = 2.67, 95% CI 1.95‒3.40; girls AAPC = 2.38, 95% CI 1.41‒3.66), and 50+ adults (males AAPC = 1.7, 95% CI 0.55‒2.86; females AAPC = 3.0, 95% CI 1.76‒4.25), including a 147% AIR increase among males aged 75+. Myeloid leukemia (AAPC = 2.68, 95% CI 0.67‒3.66) became the most common type after 2019, overtaking lymphoid leukemia. Regionally, Riyadh had the highest overall burden (ASR = 6.7), while the Northern region exhibited the fastest growth (AAPC = 10.51, 95% CI 4.09‒16.89). Qassim was the sole exception (AAPC = - 4.54, 95% CI -6.43‒-2.63).

Leukemia incidence in Saudi Arabia is accelerating at a rate exceeding global trends, highlighting the need for targeted, regionally adapted surveillance. Further research into underlying demographic and regional drivers is essential to guide effective cancer control planning.