Epidemiological trends and patterns of Hodgkin lymphoma among Saudis

Hodgkin lymphoma is one of the most common malignancies reported in Saudi Arabia and is curable if detected early. An analysis of the epidemiology of Hodgkin lymphoma in Saudi Arabia may help identify epidemiological trends of the disease and, consequently, highlight potential areas for targeted interventions.

A retrospective population-based trend study was conducted to analyze data on the number of cases, age at diagnosis, gender, morphological subtypes, stage at diagnosis and regional distribution from 2011 to 2020, as published by the Saudi Cancer Registry (SCR). Descriptive statistical analyses were performed to evaluate temporal trends in incidence, stage distribution, morphological subtypes, and regional variation. Age-standardized incidence rates (ASR) were calculated using direct standardization. Temporal trends were assessed using log-linear regression to estimate the average annual percent change (APC).

A total of 4,563 cases of Hodgkin lymphoma were recorded over the span of the 10-year surveillance period. The proportion of Hodgkin lymphoma cases increased from 3.1% to 4.1% of cancer cases that were reported. The ASR increased from 1.8 to 2.7 per 100,000 individuals, accompanied by a statistically significant APC of +5.08% (p < 0.001). Male subjects exhibited a higher APC of +5.60% compared to females (+3.38%). A bimodal age distribution was observed, peaking at 15-19 years in males and 20-24 years in females. Morphologically, HL Not Otherwise Specified (NOS) showed a substantial increase from 13.6% to 56.2%, surpassing Nodular Sclerosis as the predominant subtype by the year 2020. While diagnoses at a distant stage remained prevalent, localized-stage diagnoses increased from 29.8% to 37.5% by 2018. Najran recorded the highest regional APC of +18.4%, whereas Madinah exhibited a notable and statistically significant decline of -4.3%.

There is an increasing proportion of cancer cases attributable to Hodgkin lymphoma. The rising incidence of Hodgkin lymphoma is characterized by a shift toward the NOS (Not Otherwise Specified) subtype and significant geographical disparities. Furthermore, a trend toward diagnosis at earlier clinical stages suggests potential improvements in early detection.