Yamamoto Jennifer F, Goodman Marc T
Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813, USA.
Cancer Causes Control. 2008 May;19(4):379-90. doi: 10.1007/s10552-007-9097-2. Epub 2007 Dec 7.
Efforts to prevent leukemia have been hampered by an inability to identify significant risk factors. Exploring incidence patterns of leukemia subtypes by sex and race/ethnic group may generate new etiologic hypotheses and identify high-risk groups for further study.
Data from the North American Association of Central Cancer Registries for 1997-2002 were used to assess patterns of leukemia incidence by subtype, sex, age, race and ethnicity.
A total of 144,559 leukemia cases were identified, including 66,067 (46%) acute and 71,860 (50%) chronic leukemias. The highest rates of acute myeloid leukemia with and without maturation were observed in Asian-Pacific Islanders (API). Hispanics had a higher incidence of acute lymphocytic leukemia, particularly in childhood, and promyelocytic leukemia than did non-Hispanics. African-Americans had the highest rates of HTLV-1 positive adult T-cell leukemia/lymphoma. A sharp increase in the incidence of chronic myeloid leukemia was observed for both APIs and Hispanics, 85 years and older.
Known risk factors are unlikely to explain the observed disparities in leukemia incidence. Further studies of differences in environmental and genetic risk factors in these populations by specific leukemia subtype may provide clues to the etiologies of these malignancies.
由于无法确定重要的风险因素，白血病预防工作受到了阻碍。按性别和种族/族裔群体探究白血病亚型的发病模式，可能会产生新的病因假设，并确定高危人群以便进一步研究。
利用北美中央癌症登记协会1997 - 2002年的数据，按亚型、性别、年龄、种族和族裔评估白血病的发病模式。
共确定了144,559例白血病病例，其中包括66,067例（46%）急性白血病和71,860例（50%）慢性白血病。亚太岛民（API）中急性髓系白血病伴成熟和不伴成熟的发病率最高。西班牙裔急性淋巴细胞白血病发病率较高，尤其是在儿童期，其早幼粒细胞白血病的发病率也高于非西班牙裔。非裔美国人成人T细胞白血病/淋巴瘤HTLV - 1阳性率最高。85岁及以上的亚太岛民和西班牙裔慢性髓系白血病发病率急剧上升。
已知的风险因素不太可能解释所观察到的白血病发病率差异。针对这些人群中特定白血病亚型的环境和遗传风险因素差异进行进一步研究，可能会为这些恶性肿瘤的病因提供线索。
