Yin Xuejiao, Chen Lei, Fan Fengjuan, Yan Han, Zhang Yuyang, Huang Zhenli, Sun Chunyan, Hu Yu
Tongji Medical College, Institute of Hematology, Union Hospital, Huazhong University of Science and Technology, Wuhan, China.
Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2020 Sep 10;10:1712. doi: 10.3389/fonc.2020.01712. eCollection 2020.
The incidence of Waldenström macroglobulinemia (WM) has increased in certain groups over several decades in the United States. It is unclear whether the increasing incidence is associated with mortality trends. The incidence and incidence-based mortality (IBM) rates were obtained from the Surveillance, Epidemiology, and End Results (SEER) database (1980-2016) with SEERStat software. The secular trends stratified by demographic characteristics were analyzed by joinpoint regression. The incidence of WM showed an initial rapid increase from 1980 to 1993 {annual percentage change (APC), 14.1% [95% confidence interval (CI), 10 to 18.4%]}, whereas it began to stabilize from 1993 to 2016 [APC, 0.5% (95% CI, -0.3 to 1.3%)]. The WM IBM trend followed a similar pattern, with a decrease occurring around 1994. The trends in the incidence and mortality significantly differed according to geographic location, race, age, sex, primary site of involvement and subtype, which could help in further investigations into the specific etiology. Moreover, a dramatic increase in the 5-year survival rate from the 1980s to 2010s was observed (47.84 vs. 69.41%). Although both the incidence and IBM of WM continued to increase during the study period, a reduction in the rate of increase occurred around 1993. We believe that further advances in healthcare delivery and research can ensure a low mortality rate. Future studies can use the findings of this paper to monitor the results of WM therapy.
在美国,几十年来某些人群中瓦尔登斯特伦巨球蛋白血症(WM)的发病率有所上升。目前尚不清楚发病率的上升是否与死亡率趋势相关。利用SEERStat软件从监测、流行病学和最终结果(SEER)数据库(1980 - 2016年)中获取发病率和基于发病率的死亡率(IBM)数据。通过连接点回归分析按人口统计学特征分层的长期趋势。WM的发病率在1980年至1993年期间最初迅速上升{年百分比变化(APC),14.1%[95%置信区间(CI),10%至18.4%]},而在1993年至2016年开始趋于稳定[APC,0.5%(95%CI, - 0.3%至1.3%)]。WM的IBM趋势遵循类似模式,在1994年左右出现下降。发病率和死亡率趋势在地理位置、种族、年龄、性别、受累原发部位和亚型方面存在显著差异,这有助于进一步调查具体病因。此外,观察到从20世纪80年代到21世纪10年代5年生存率有显著提高(47.84%对69.41%)。尽管在研究期间WM的发病率和IBM持续上升,但在1993年左右上升速度有所下降。我们相信医疗保健服务和研究的进一步进展可以确保低死亡率。未来的研究可以利用本文的研究结果来监测WM治疗的效果。