Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, University of Kuwait, PO Box 24923, 13110, Safat, Kuwait.
Department of Surgery, Farwaniya Hospital, PO Box 33978, 7346, Al Rawdha, Kuwait.
Cancer Causes Control. 2020 Mar;31(3):231-240. doi: 10.1007/s10552-020-01267-3. Epub 2020 Jan 20.
This retrospective cohort study examines the trends in childhood leukaemia age-standardized incidence rates (ASIRs) (per million person-years) using cases which were diagnosed at age 0-19 years from 1980 to 2014 and recorded in the Kuwait Cancer Control Center (KCCC) registry.
Childhood leukaemia age-specific incidence rates overall and by sub-cohorts defined by age (0-4, 5-9, 10-14, and 15-19 years), sex (male, female) and nationality (Kuwaiti, non-Kuwaiti) were computed and age-standardized. Joinpoint regression models were used to evaluate trends in childhood leukaemia ASIRs. Average annual percent change (AAPC) and its 95% confidence interval (CI) were used to interpret the observed trends.
During the study period, 1077 childhood leukaemia cases of 32.3 million person-years were diagnosed. From 1980 to 2014, the average annual childhood leukaemia ASIR was 53.1 (95% CI 20.9, 85.2). Overall childhood leukaemia ASIRs significantly decreased on average by 6.8% per year (AAPC = -6.8; 95% CI -12.1, -1.1; p = 0.02) from 1980 to 1993, but a marginally significant increase in ASIRs from 1993 to 2014 was recorded (AAPC = 2.5; 95% CI -0.5, 5.5; p = 0.10). During the entire period, childhood leukaemia ASIRs trends significantly (p < 0.05) increased among 6 of 16 sub-cohorts, which was more pronounced among females and 10-14-year-old children.
Overall, ASIRs significantly increased from 1993 to 2014, which specifically seems to be driven by an increase in ASIRs among females and 10-14 -year-old children. These increasing trends underscore the potential involvement of a range of exposures. Future studies on unravelling such factors may help develop preventive measures to minimize childhood leukaemia risk in this and similar settings in the region.
本回顾性队列研究使用科威特癌症控制中心（KCCC）登记处记录的 1980 年至 2014 年期间诊断为 0-19 岁的病例，研究了儿童白血病年龄标准化发病率（ASIR）（每百万人口年）的趋势。
计算并年龄标准化了儿童白血病的年龄特异性发病率（总体及按年龄亚组（0-4 岁、5-9 岁、10-14 岁和 15-19 岁）、性别（男、女）和国籍（科威特人、非科威特人）的发病率）。使用 Joinpoint 回归模型评估儿童白血病 ASIR 趋势。平均年百分比变化（AAPC）及其 95%置信区间（CI）用于解释观察到的趋势。
在研究期间，诊断出 1077 例儿童白血病，共 3230 万人年。1980 年至 2014 年，儿童白血病的平均年 ASIR 为 53.1（95%CI 20.9，85.2）。总体而言，儿童白血病 ASIR 平均每年下降 6.8%（AAPC=-6.8；95%CI-12.1，-1.1；p=0.02），从 1980 年至 1993 年，但记录到 1993 年至 2014 年 ASIR 略有增加（AAPC=2.5；95%CI-0.5，5.5；p=0.10）。在整个期间，16 个亚组中有 6 个亚组的儿童白血病 ASIR 趋势显著（p<0.05）增加，其中女性和 10-14 岁儿童的增加更为明显。
总体而言，ASIR 从 1993 年至 2014 年显著增加，这似乎主要是由于女性和 10-14 岁儿童的 ASIR 增加所致。这些上升趋势强调了一系列潜在暴露因素的作用。未来关于揭示这些因素的研究可能有助于制定预防措施，以最大限度地降低该地区类似环境中儿童白血病的风险。
