1997 年至 2016 年瑞士慢性淋巴细胞白血病/小淋巴细胞淋巴瘤的发病率、死亡率和生存率趋势：一项基于人群的研究。

Trends of incidence, mortality and survival for chronic lymphocytic leukaemia / small lymphocytic lymphoma in Switzerland between 1997 and 2016: a population-based study.

机构信息

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Foundation National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Switzerland / National Agency for Cancer Registration (NACR) operated by NICER, c/o University of Zurich, Switzerland.

出版信息

Swiss Med Wkly. 2021 Mar 15;151:w20463. doi: 10.4414/smw.2021.20463.

DOI:10.4414/smw.2021.20463

PMID:33793959

Abstract

BACKGROUND

During the last 20 years, treatment for chronic lymphocytic leukaemia (CLL) / small lymphocytic lymphoma (SLL) has advanced, with improved clinical outcomes in randomised controlled trials. Currently, no data have been published from Switzerland to assess effectiveness of recent healthcare advances in CLL/SLL on a population-based level. We aimed to estimate trends in incidence, mortality and survival for patients with CLL/SLL in Switzerland.

METHODS

We retrospectively studied registry data from the National Agency for Cancer Registration (NACR) database in Switzerland from 1997 to 2016. We investigated incidence, mortality and survival in consecutive 5-year periods. Age-specific rates were calculated for three age groups (<65 years, 65–74 years and ≥75 years).

RESULTS

We obtained 6301 cases with CLL/SLL. Median age at diagnosis was 72 years. From 7.0 per 100,000 person-years in 1997–2002, age-adjusted incidence rates peaked at 7.8 per 100,000 person-years in the second time period, 2002–2006, and declined afterwards to 6.4 per 100,000 person-years in 2012–2016. Mortality declined from 2.4 per 100,000 person-years in 1997–2002 to 2.0 per 100,000 in 2012–2016. Five- and 10-year age-standardised relative survival increased from 77.9% and 55.6%, respectively, in 1997–2001 to 83.6% (p = 0.009) and 64.2% (p = 0.005), respectively, in 2012–2016. Improvement in age-specific relative survival was only significant in the middle age group (65–74 years). Incidence and mortality were significantly higher in males. Females had better relative survival.

CONCLUSION

We found no clear down- or upward trend in age-adjusted incidence rates. Age-standardised survival improved over time, mainly in the two younger age-groups, but this improvement was statistically significant in those aged 65–74 years only. Males have higher incidence rates, higher mortality and shorter survival than females. Reporting delay and underreporting are major limitations in the interpretation of registry data from patients diagnosed with CLL/SLL.

摘要

背景

在过去的 20 年中，慢性淋巴细胞白血病（CLL）/小淋巴细胞淋巴瘤（SLL）的治疗取得了进展，随机对照试验的临床结果得到了改善。目前，瑞士尚无数据发表，以评估最近在 CLL/SLL 方面的医疗保健进展对人群水平的有效性。我们旨在评估瑞士 CLL/SLL 患者的发病率、死亡率和生存率趋势。

方法

我们回顾性地研究了瑞士国家癌症登记处（NACR）数据库中 1997 年至 2016 年的登记数据。我们在连续的 5 年期间研究了发病率、死亡率和生存率。为三个年龄组（<65 岁、65-74 岁和 ≥75 岁）计算了年龄特异性比率。

结果

我们获得了 6301 例 CLL/SLL 病例。诊断时的中位年龄为 72 岁。从 1997-2002 年的每 100,000 人 7.0 例，调整年龄后的发病率在 2002-2006 年的第二个时期达到峰值，每 100,000 人 7.8 例，此后下降至 2012-2016 年的每 100,000 人 6.4 例。死亡率从 1997-2002 年的每 100,000 人 2.4 例下降到 2012-2016 年的每 100,000 人 2.0 例。5 年和 10 年的年龄标准化相对生存率分别从 1997-2001 年的 77.9%和 55.6%提高到 2012-2016 年的 83.6%（p = 0.009）和 64.2%（p = 0.005）。仅在中年组（65-74 岁）中观察到年龄特异性相对生存率的改善具有统计学意义。男性的发病率和死亡率较高，而女性的生存率较好。