Barrington-Trimis Jessica L, Cockburn Myles, Metayer Catherine, Gauderman W James, Wiemels Joseph, McKean-Cowdin Roberta
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
School of Public Health, University of California Berkeley (UCB), Berkeley, CA.
Int J Cancer. 2017 Mar 1;140(5):1000-1008. doi: 10.1002/ijc.30487. Epub 2016 Nov 30.
Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0-19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC) = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10-14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non-Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non-Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1-4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10-14, and 15-19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.
在过去几十年里，美国儿童白血病的发病率稳步上升，但直到最近，发病率上升方面的差异才被认识到。在当前分析中，利用监测、流行病学和最终结果（SEER）数据评估了1992年至2013年期间0至19岁儿童白血病诊断发病率的近期趋势，包括总体情况以及按年龄、种族/族裔、性别和组织学亚型分类的情况。2009年至2013年期间，西班牙裔白人儿童比非西班牙裔白人、非西班牙裔黑人或非西班牙裔亚裔儿童更有可能被诊断为急性淋巴细胞白血病（ALL）。1992年至2013年期间，观察到西班牙裔白人儿童的ALL发病率显著上升[年百分比变化（APC）=1.08，95%置信区间：0.59，1.58]；非西班牙裔白人、黑人或亚裔儿童未观察到显著上升。1992年至2013年期间，15至19岁被诊断的西班牙裔白人儿童的ALL发病率每年增加约3%（APC=2.67；95%置信区间：0.88，4.49），10至14岁的儿童增加2%（APC=2.09；95%置信区间：0.57，3.63），而相同年龄的非西班牙裔白人、黑人或亚裔儿童发病率未观察到显著增加。急性髓细胞白血病（AML）发病率在诊断时年龄小于1岁的非西班牙裔白人儿童以及1至4岁被诊断的西班牙裔白人儿童中有所增加。儿童ALL发病率的上升似乎是由年龄较大的西班牙裔儿童（10至14岁和15至19岁）发病率上升所驱动。未来需要开展研究以评估年龄较大的西班牙裔儿童ALL发病率上升的原因。
