Changing Burden of Haematolymphoid Tumours in AYA in Poland: Organizational Challenges for the Healthcare System (Current Status and Future Perspectives).

Background/Objectives: Hematological malignancies (HMs) are an important component of the cancer burden in adolescents and young adults (AYA, 15-39 years), requiring long-term specialized care. In Poland, recent healthcare reforms under the National Oncology Network (KSO) have not formally included haemato-oncology or AYA-specific needs. Methods: A population-based study was conducted using data from the Polish National Cancer Registry. AYAs diagnosed with HM between 2000 and 2022 were included. Descriptive analyses and projections were based on cases diagnosed between 2000 and 2022, whereas age-specific incidence trend analyses were restricted to the 2015-2022 period. Tumours were classified according to the HAEMCARE framework. Age-standardized incidence rates (ASIRs), annual percentage changes (APCs), and short-term projections through 2028 were estimated using generalized linear models. Additionally, data from the National Health Fund (NFZ) were analyzed to assess the geographical distribution of reimbursed drug programmes dedicated to selected HMs. Results: A total of approximately 23,000 AYA patients diagnosed with HMs were identified. Hodgkin lymphomas (HL) were the predominant tumour type across all age groups, while lymphoblastic leukemia/lymphoma was most common among younger AYAs and diffuse large B-cell lymphoma (DLBCL) increased in relative importance with age. Between 2015 and 2022, ASIRs remained stable only in two age groups (20-24 and 25-29), whereas statistically significant increases were observed among individuals aged 15-19, 30-34 and 35-39 years. Despite largely stable incidence patterns, projections indicated a growing absolute number of cases for DLBCL and follicular lymphomas. Analysis of NFZ data revealed substantial regional variation in the availability of reimbursed drug programmes, with up to six-fold differences in facility density between voivodships. Conclusions: HM epidemiology among AYAs in Poland is characterized by increasing incidence in selected lymphoma subtypes alongside declining mortality. Incorporating haemato-oncology and AYA-specific needs into national cancer planning frameworks should therefore be considered essential for future healthcare system preparedness.