Burden, Temporal Trends, and Projections of Hodgkin Lymphoma in South Asia, 1990–2040: A Systematic Analysis of the Global Burden of Disease Study 2023

Background Hodgkin lymphoma (HL) is a highly curable malignancy, yet its burden and trajectory in South Asia remain poorly characterized. We quantified the burden, temporal trends, and future projections of HL across South Asia and its five constituent countries. Methods Using Global Burden of Disease (GBD) 2023 estimates, we extracted age-standardized rates and absolute counts of HL incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for 1990–2023. Joinpoint regression estimated average annual percentage changes (AAPCs); Kitagawa decomposition partitioned crude-rate changes into epidemiological and demographic components; and autoregressive integrated moving average (ARIMA) models projected burden to 2040. Results Between 1990 and 2023, regional age-standardized incidence (AAPC − 1.35%), mortality (− 2.12%), and DALY rates (− 2.15%) all declined significantly, while prevalence remained stable. Bangladesh, Nepal, and India achieved the largest improvements, whereas Pakistan showed the slowest progress and, by 2023, the highest incidence (1.09), mortality (0.74), prevalence (3.61), and DALY (36.31 per 100,000) rates in the region. Despite falling rates, absolute incident and prevalent cases rose across South Asia, driven predominantly by population growth and ageing, as confirmed by decomposition. ARIMA projections indicate continued declines in mortality and DALYs through 2040, with Pakistan retaining a disproportionately high burden. Conclusions HL burden has declined substantially across South Asia over three decades, but marked cross-country disparities persist, with Pakistan lagging. Strengthening cancer registries, promoting early diagnosis, and expanding equitable access to treatment—particularly in Pakistan—are priorities for further reducing the regional burden.