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Created at 5am, Mar 14
HephaestionMedicine
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A Comprehensive Two-Decade Analysis of Lymphoma Incidence Patterns in Saudi Arabia
Contract ID
JbNJ97rFEEvSGImalY215SpGFGfCVZLh_uLyqoLt8MU
File Type
PDF
Entry Count
60
Embed. Model
jina_embeddings_v2_base_en
Index Type
hnsw

Lymphomas account for approximately 10% of all cancer cases among the Saudi population. Even when separated, Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are in the top ten most commonly diagnosed cancers among Saudi men and women. Despite the substantial cost of HL and NHL to public health, the resources to assess their impact are insufficient. This study provides a two-decade detailed assessment of lymphoma incidence trends in the Saudi population. Methods: Analysis of the Saudi Cancer Registry (SCR) data for various incidence metrics from 2001 to 2020 was conducted. Joinpoint regression analysis was further performed to investigate temporal trends globally and by age group, gender, and administrative region. Results: HL cases grew by 174.1%, whereas NHL cases increased by only 80% for that time period. The HL overall Age-Standardized Incidence Rate (ASR) increased by 100% for both genders combined but remained unchanged for NHL. The median age at diagnosis for HL (20–30 years) and NHL (46–57 years) was lower than in many other nations. Our model identified increasing trends for HL with annual percentage changes (APCs) of 2.94% (CI: 2.2–3.7) and 3.67% (CI: 2.6–4.7) for males and females, respectively. The rise was mainly among young groups under 40. On the contrary, the NHL cohort revealed notable declining tendencies. We discovered alarming rates of HL in Saudi Arabia’s APC (2.23% for males and 3.88% for females) and ASR compared to other Western countries. Overall, the majority of the patients presented with advanced-stage disease at a younger age and with slight male predominance. Conclusions: The overall incidence of lymphoma (especially HL) has been rising among Saudis. Implementation of secondary and tertiary prevention measures, as well as management of modifiable risk factors, is warranted.

The median age at diagnosis varied according to the lymphoma subtype. In our study, the median age at diagnosis for HL kept fluctuating between 20 and 30 years and showed similar patterns for both genders. In NHL, it was often greater in females than in males (4957 and 4654 years, respectively). These findings are consistent with previous studies from Saudi Arabia . The median age at diagnosis for HL and NHL is younger compared to Western countries. In the West, the median age of HL diagnosis is mid30s , while for NHL it is 67 . The considerably younger median age of diagnosis among Saudis is not restricted to lymphoma but has also been reported in other cancer types, such as breast and colorectal cancers [13,14,25,26]. Of note, over 60 percent of the population in Saudi Arabia is under 30 years old, which could explain this trend. Other possible explanations include childhood exposure to viral agents like EpsteinBarr Virus (EBV) and Hepatitis C virus (HCV), as well as
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With their high consanguinity, Saudi Arabians would be a great candidate population for uncovering lymphoma susceptibility genes.
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Our prediction model to anticipate the trends of HL and NHL for the period of 20012020 discovered multiple outcomes. The model indicated that HL trends were increasing, with annual percentage changes (APCs) for males and females of 2.94% and 3.67%, respectively. Age-specific analysis of the APC in the HL group revealed that the increase is mainly among the young groups below 40, signifying the notion of spread among younger ages. On the contrary, the NHL cohort revealed notable dropping tendencies, with males exhibiting a 1.36% drop from 2005 to 2020 and females showing a 1.43% decrease from 2007 to 2020. Our findings coincide with the universal trend of increased HL and subsided/decreased NHL incidence. In the United States, following a long history of growth, the incidence of NHL declined by approximately 1% per year from 2015 to 2019 . The growing increase in NHL incidence has also been reported in multiple European countries, particularly Spain and the Nordic countries
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. Our region-specific examination discovered multiple trends in the HL cohort. The only regions with a noticeably rising tendency in both genders were Riyadh and the Eastern regions. Considering that these two regions comprise the largest portion of the kingdom and accommodate over 40% of its population, these findings are probably not surprising. Asir was male-specific, whereas Jouf, Qassim, Tabuk, Baha, and Jazan showed an increase in the female cohort. Furthermore, during our investigation over a 15-year period (20022016), we found alarming rates of
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