Hematologic Cancers in the SAARC Region: Current Burden in 2022 and Projections to 2050 Open Access

1. Hematologic malignancies in the SAARC region pose a growing burden, with incidence and mortality varying across countries

2. Disparities in healthcare infrastructure contribute to high mortality-to-incidence ratios, and require regionally tailored strategies

South Asia, comprising the SAARC nations, bears a disproportionately high cancer mortality relative to incidence. Hematologic malignancies, though potentially curable with timely diagnosis and treatment, remain understudied in this region. We examined the burden, distribution, and future projections of hematologic cancers across SAARC countries to inform equitable cancer control strategies. We used GLOBOCAN 2022 data from the Global Cancer Observatory and UN population estimates to assess incidence and mortality for non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), leukemia, and multiple myeloma across SAARC countries. We report age-standardised incidence and mortality rates (ASIR/ASMR) per 100,000, and mortality-to-incidence ratios (MIRs). Future projections to 2045 were estimated under constant rate assumptions. In 2022, 148,312 hematologic cancers were diagnosed in the SAARC region, including 63,448 cases of leukemia, 52,363 cases of NHLs, 19,922 cases of multiple myeloma, and 12,579 cases of Hodgkin lymphoma. India accounted for over three-quarters of all cases, followed by Pakistan. In terms of age-standardized incidence rates, leukemia was the most common subtype, with highest ASIR in Maldives (6.7 per 100,000 males) and highest ASMR in Pakistan (3.4 per 100,000). In 2022, 30582 deaths from NHL, 4645 deaths from Hodgkin’s lymphoma, 17199 deaths from multiple myeloma, and 46671 deaths from leukemia occurred in SAARC. MIRs ranged widely, from 0.52 (Sri Lanka, NHL) to 1.0 (Bhutan, multiple myeloma). By 2045, 236,000 new cases and 163,149 deaths are projected, with India bearing the greatest burden. Substantial disparities in diagnostic access and healthcare infrastructure persist.