https://orcid.org/0000-0001-9982-3223
In this issue of Blood Global Hematology, Hammond et al1 analyzed hematologic malignancies in the SAARC (South Asian Association for Regional Cooperation) region, offering valuable epidemiologic insights into the distribution and projected burden of leukemia, non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and multiple myeloma. Drawing on the GLOBOCAN 2022 data and United Nations population estimates, the authors present a compelling case for the urgency of cancer control strategies in South Asia, where mortality-to-incidence ratios (MIR) remain alarmingly high.
However, the study’s strength in quantitative cancer burden modeling is offset by a notable omission: the absence of health system metrics. Not integrating databases such as World Health Organization,2,3 the World Bank,4 and United Nations Development Programme into the analysis is a missed opportunity, limiting the interpretive depth of the findings, particularly regarding the wide variation in MIR across countries (ie, from 0.52 in Sri Lanka [NHL] to 1.0 in Bhutan [multiple myeloma]). Such disparities likely reflect differences in diagnostic capacity, access to hematology care, and treatment infrastructure rather than epidemiologic variation alone.1
For hematologic malignancies, many of which are potentially curable with timely intervention, the omission of system-level indicators such as radiotherapy availability, hematopathology services, transfusion support, and access to chemotherapy regimens is a missed opportunity. These metrics are essential to contextualize disease outcomes and to inform targeted investments in cancer-care delivery.
Moreover, India’s disproportionate share of cases and deaths underscores the need for subnational analyses that account for regional disparities in health care access and quality. Without health system data, projections to 2045 risk being interpreted in isolation, detached from the operational realities that shape cancer outcomes.
In conclusion, although the study provides a robust epidemiologic foundation, future research must incorporate health system metrics to enable a more holistic and actionable understanding of hematologic cancer burden in South Asia. Such integration is critical for designing equitable and effective cancer control strategies in resource-constrained settings.
Conflict-of-interest disclosure: The author declares no competing financial interests.
