Hodgkin Lymphoma in the Middle Euphrates Region of Iraq: Demographic and Histopathologic Insights

Background: Hodgkin Lymphoma (HL) is among the top ten cancers affecting children and young adults in Iraq, yet epidemiologic and clinical data remain limited. Objective: To identify the epidemiologic and histopathologic trends of HL patients in the Middle Euphrates region of Iraq. Materials and Methods: Medical information of patients registered at the Middle Euphrates Cancer Centre from January 2020 to December 2024 was retrospectively collected and analysed. Demographic, histopathologic, and clinical staging data were extracted. The data were summarized, and correlations were assessed using 95% confidence interval and a significance level of < 0.05. Results: A total of 293 HL cases were included with a median age of 28 years, and a male-to-female ratio of 1.22:1. Seventy percent of patients were younger than 40 years, with a dominant peak between 10 and 30 years. Nodular sclerosis (NS) and mixed cellularity (MC) were the dominant histologic subtypes (40.27% and 38.91%, respectively). NS subtype was significantly more likely to present in pediatric and younger age groups (P-value < 0.001) and at an earlier stage (P-value = 0.018). Conversely, MC showed a tendency to affect older adults (P-value = 0.014). Paediatric and young age groups had higher odds of presenting at an earlier stage than older adults (OR=3.56, P-value=0.031, 95%CI:1.12-11.36) and (OR=5.35, P-value=0.001, 95%CI:1.92-14.93), respectively. Conclusion: HL mainly affects younger age groups, with NS and MC being the most prevalent subtypes. Younger age and NS subtype are significantly associated with earlier stage at presentation, suggesting the need for more age-specific diagnostic and management strategies in this patient population.