Long term trends in Hodgkin's lymphoma incidence in the United States and Puerto Rico, 1999 to 2022.

e19043 Background: Hodgkin lymphoma (HL) is a highly curable malignancy; however, population-level incidence trends vary across demographic subgroups. Contemporary national data describing long-term HL incidence patterns across age, sex, and race/ethnicity remain limited. We evaluated temporal trends in HL incidence in the United States from 1999 to 2022. Methods: Incident HL cases from 1999 to 2022 were obtained from the United States Cancer Statistics (USCS) Incidence database via CDC WONDER. Age-adjusted incidence rates were calculated per 100,000 population using the 2000 U.S. standard population. Trends were assessed overall and stratified by sex, age (<25, 25–44, 45–64, ≥65 years), race and ethnicity (Non-Hispanic White, NH Black's, NH Asian or Pacific Islander, NH American Indian or Alaska Native, and Hispanic). Joinpoint regression was used to estimate average annual percent change (AAPC) with 95% confidence intervals (CI). Results: A total of 204,884 incident HL cases were identified in the United States between 1999 and 2022. Overall age-adjusted HL incidence declined from 2.79 in 1999 to 2.48 in 2022, corresponding to an AAPC of −0.57% (95% CI, −0.68 to −0.46). Incidence rates were consistently higher among males than females across all years, with steeper declines among males (AAPC −0.63%; 95% CI, −0.79 to −0.43) compared with females (AAPC −0.43%; 95% CI, −0.57 to −0.26). Age-stratified analyses demonstrated stable incidence among individuals aged <25 years (AAPC 0.12%; 95% CI, −0.02 to 0.30), while sustained declines were observed among adults aged 25–44 years (AAPC −0.71%; 95% CI, −0.91 to −0.46), 45–64 years (AAPC −0.61%; 95% CI, −0.86 to −0.36), and ≥65 years (AAPC −0.59%; 95% CI, −0.81 to −0.32). Incidence declined among NH White's (AAPC −0.66%; 95% CI, −0.81 to −0.49) and Hispanic individuals (AAPC −0.55%; 95% CI, −0.80 to −0.27). In contrast, incidence increased among NH Black's (AAPC 0.27%; 95% CI, 0.00 to 0.57) and NH Asian or Pacific Islander's (AAPC 0.75%; 95% CI, 0.38 to 1.21), while no consistent long-term trend was observed among NH American Indian or Alaska Native individuals (AAPC 0.32%; 95% CI, −0.73 to 1.50). Conclusions: Hodgkin lymphoma incidence in the United States declined steadily from 1999 to 2022, driven primarily by reductions among adults aged ≥25 years and White and Hispanic populations. In contrast, increasing incidence among Black or African American and Asian or Pacific Islander individuals highlights emerging demographic divergence in disease burden, warranting further investigation.