Programa de Hematologia-Oncologia Pediátrica - PHOP, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil.
Divisão de Vigilância e Análise de Situação, Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil.
Cancer Epidemiol. 2019 Oct;62:101583. doi: 10.1016/j.canep.2019.101583. Epub 2019 Aug 28.
Myeloid malignancies (MM) are heterogeneous when it comes to incidence rates and pathogenesis. These variation rates are important to generate hypotheses on causal aetiology. This study aimed to describe incidence and mortality patterns of MM among children, adolescents and young adults (cAYA) in Brazil and to evaluate trends in incidence and mortality rate overtime.
Data were extracted from a dataset of 15 Population-based Cancer Registries located in five Brazilian geographical regions and calculated by age-specific, crude, and age-standardized incidence (ASR) and mortality rates per million persons. Joinpoint regression analyses were performed for trends evaluations, regionally. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were also estimated.
The overall ASR for incidence and mortality of MM in Brazil was 14.57 and 8.83 per million, respectively. The AML (non-APL AML and APL) incidence rate is 8.18 per million, whereas other MM subtypes altogether have an incidence rate of 2.62 per million, and not otherwise specified (NOS) is 3.70 per million. The analysis of incidence trends (AAPC) showed a significant decline in Manaus (-5.6%) and São Paulo (-4.7%), and a significant increase was observed in Fortaleza (5.8%). Mortality trends steadily declined in all registries, with significant declines occurring in Goiânia (-1.5%), Belo Horizonte (-2.3%), São Paulo (-2.5%), Curitiba (-2.8%) and Porto Alegre (-4.1%).
Our findings showed differences in the incidence and mortality rates of MM in cAYA in Brazil, geographically. Infants-AML have the highest incidence within the cAYA population (17.42 per million). There was a substantial decrease in mortality rate observed, which was interpreted as an improvement in MM recognition and therapeutic approach.
髓系恶性肿瘤(MM)在发病率和发病机制方面存在异质性。这些变化率对于产生关于因果病因的假说很重要。本研究旨在描述巴西儿童、青少年和年轻成人(cAYA)中 MM 的发病和死亡模式,并评估随时间推移发病率和死亡率的趋势。
数据从位于巴西五个地理区域的 15 个基于人群的癌症登记处的数据集中提取,并按年龄特异性、粗发病率和年龄标准化发病率(ASR)以及每百万人的死亡率计算。对区域趋势进行了 Joinpoint 回归分析。还估计了年度百分比变化(APC)和平均年度百分比变化(AAPC)。
巴西 MM 的总发病率和死亡率的 ASR 分别为 14.57 和 8.83/百万人。AML(非 APL AML 和 APL)的发病率为 8.18/百万人,而其他 MM 亚型的总发病率为 2.62/百万人,未另作说明(NOS)的发病率为 3.70/百万人。发病率趋势的分析(AAPC)显示马瑙斯(-5.6%)和圣保罗(-4.7%)的发病率显著下降,而福塔雷萨(5.8%)的发病率显著上升。所有登记处的死亡率趋势均稳步下降,戈亚尼亚(-1.5%)、贝洛奥里藏特(-2.3%)、圣保罗(-2.5%)、库里蒂巴(-2.8%)和阿雷格里港(-4.1%)的死亡率下降显著。
我们的研究结果表明,巴西 cAYA 中 MM 的发病率和死亡率存在地域差异。婴儿-AML 在 cAYA 人群中的发病率最高(17.42/百万人)。死亡率的大幅下降表明 MM 的认识和治疗方法有所改善。