Global, regional, and national patterns of change in the burden of Hodgkin lymphoma from 1990 to 2021: an analysis of the global burden of disease study 2021 and projections to 2035

Hodgkin's lymphoma (HL), a malignant neoplasm of lymphatic system origin, poses a significant challenge to global public health. This study comprehensively analyzed global, regional, and national trends in HL burden from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) Study 2021, and projected these trends to 2035. The HL burden was assessed through age-standardized incidence (ASIR), prevalence (ASPR), disability-adjusted life years (DALYs) rates, and mortality (ASMR) from 1990 to 2021. Analytical methods included the Slope Index of Inequality (SII), concentration index, frontier analysis, decomposition analysis, joinpoint regression, and Bayesian age-period-cohort (BAPC) modeling. Between 1990 and 2021, global Hodgkin's lymphoma incidence, DALYs, and mortality rates exhibited sustained downward trends. New cases increased from 54,671 (95% UI: 45,648.6-59,832.2) to 65,182 (95% UI: 53,167.4-77,143.0), yet the incidence rate declined from 1.119 (95% UI: 0.935-1.227) to 0.794 (95% UI: 0.645-0.941). DALYs decreased from 1,324,591 (95% UI: 959,601.5-1,519,698.0) to 1,196,188 (95% UI: 847,435.8-1,528,816.4), with the rate falling from 26.055 (95% UI: 18.977-29.882) to 14.818 (95% UI: 10.434-18.955). Deaths dropped from 28,977 (95% UI: 21,389.7-33,106.9) to 28,180 (95% UI: 20,895.4-35,652.9), and the mortality rate decreased from 0.633 (95% UI: 0.474-0.722) to 0.341 (95% UI: 0.252-0.431). Males generally had higher incidence, DALYs, and mortality rates than females, with smaller sex differences in high-income regions. Children and adolescents had relatively lower rates, which increased with age, peaking in individuals aged 60 and older. Significant regional disparities existed, with high SDI regions experiencing stable or declining rates, while low SDI regions saw slight declines in incidence and mortality but increased DALYs. In 2021, sub-Saharan Africa had higher incidence and mortality rates, while high-income regions had lower rates. The study also noted increased global inequalities in DALYs and mortality rates, with low SDI regions bearing a greater burden. While there has been a global reduction in the burden of Hodgkin's Lymphoma, substantial health disparities persist in low- and middle-income regions. Future strategies should prioritize enhancing health infrastructure, improving early detection methods, and standardizing treatment protocols in resource-constrained settings. International collaboration and efficient resource allocation are essential to mitigate global health disparities.