Linet M S, Devesa S S
Analytic Studies Section, National Cancer Institute, Bethesda, Maryland 20892.
Br J Cancer. 1991 Mar;63(3):424-9. doi: 10.1038/bjc.1991.98.
Internationally there is a 4-fold variation in age-adjusted incidence rates for childhood leukaemia (all types combined), with only slightly greater worldwide differences specifically for acute lymphocytic leukaemia (ALL) and for acute nonlymphocytic leukaemia (ANLL). Total leukaemia rates are highest among Hispanic populations in Costa Rica and Los Angeles (males), due primarily to elevated ALL incidence, while low rates occur among US blacks, Kuwaitis, Israeli non-Jews, and Bombay Indians. In most populations the patterns for ALL are similar to those for total leukaema, with peak incidence at ages 1-4 and a decline thereafter. Lower and more uniform rates are generally observed at all ages for ANLL. Age-adjusted rates for ANLL appear to vary substantially among some populations with uniform ALL incidence rates (e.g., among Asians) and yet appear to be similar in other populations with variation in ALL rates (e.g., whites and blacks in the US). Possible variation among registries in completeness of childhood leukaemia ascertainment and accuracy of diagnosis by cell type should be assessed, while case-control investigations among populations with very high and very low rates may provide useful information about the cell-type specific determinants of childhood leukaemia.
在国际上，儿童白血病（所有类型合并）的年龄调整发病率存在4倍的差异，而仅就急性淋巴细胞白血病（ALL）和急性非淋巴细胞白血病（ANLL）而言，全球差异略大。白血病总发病率在哥斯达黎加和洛杉矶的西班牙裔人群中最高（男性），主要原因是ALL发病率升高，而美国黑人、科威特人、以色列非犹太人以及孟买印度人的发病率较低。在大多数人群中，ALL的发病模式与白血病总发病模式相似，发病高峰在1至4岁，之后下降。ANLL在各年龄段的发病率通常较低且更为均匀。在一些ALL发病率一致的人群（如亚洲人）中，ANLL的年龄调整发病率似乎差异很大，而在一些ALL发病率有差异的人群（如美国的白人和黑人）中，ANLL的年龄调整发病率似乎相似。应评估儿童白血病确诊登记的完整性以及细胞类型诊断准确性方面各登记处之间可能存在的差异，而在发病率极高和极低的人群中开展病例对照研究可能会提供有关儿童白血病细胞类型特异性决定因素的有用信息。
