204个国家和地区白血病的全球负担及其归因因素：全球疾病负担2019研究结果及到2030年的预测

The Global Burden of Leukemia and Its Attributable Factors in 204 Countries and Territories: Findings from the Global Burden of Disease 2019 Study and Projections to 2030.

作者信息

Du Mengbao, Chen Weiwei, Liu Ke, Wang Limengmeng, Hu Yihan, Mao Yingying, Sun Xiaohui, Luo Yi, Shi Jimin, Shao Keding, Huang He, Ye Ding

机构信息

Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Department of Epidemiology, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China.

出版信息

J Oncol. 2022 Apr 25;2022:1612702. doi: 10.1155/2022/1612702. eCollection 2022.

BACKGROUND

Leukemia is a common malignancy that has four main subtypes and is a threat to human health. Understanding the epidemiological status of leukemia and its four main subtypes globally is important for allocating appropriate resources, guiding clinical practice, and furthering scientific research.

METHODS

Average annual percentage changes (AAPCs) were calculated to estimate the change trends of age-standardized rates (ASRs) from 1990 to 2019 in 204 countries and territories. The risk factors for leukemia death and disability-adjusted life-year (DALY) were also analyzed. In addition, the future trends in ASRs were projected through 2030.

RESULTS

The total number of incident cases, deaths, and DALYs from leukemia in 2019 was 0.64, 0.33, and 11.66 million, respectively. Decreasing trends in age-standardized incidence rate (ASIR), the age-standardized death rate (ASDR), and age-standardized DALY rate were detected on a global level while increasing trends in ASIR were detected in the high-sociodemographic index (SDI) regions. The leukemia burden was heavier in males than in females. By cause, acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL) were more likely to impose a burden on the elderly, while acute lymphoblastic leukemia (ALL) showed a greater impact in the younger population. A significant positive correlation was observed between SDI and AAPC in ASIR, while SDI was negatively correlated with AAPCs in both ASDR and age-standardized DALY rate. Smoking remained the most significant risk factor associated with leukemia-related death and DALY, especially in males. Similar deaths and DALYs were caused by smoking and high body mass index (BMI) in females. Future projections through 2030 estimated that ASIR and ASDR will continue to increase, while the DALY rate is predicted to decline.

CONCLUSIONS

Patterns and trends of leukemia burden are correlated with SDI. The estimated contributions to leukemia deaths indicate that timely measures are needed to reduce smoking and obesity.

背景

白血病是一种常见的恶性肿瘤，有四种主要亚型，对人类健康构成威胁。了解全球白血病及其四种主要亚型的流行病学状况对于合理分配资源、指导临床实践和推动科学研究至关重要。

方法

计算了1990年至2019年204个国家和地区的年龄标准化发病率（ASR）的年均变化百分比（AAPC），以估计其变化趋势。还分析了白血病死亡和伤残调整生命年（DALY）的危险因素。此外，预测了到2030年ASR的未来趋势。

结果

2019年白血病的发病例数、死亡数和DALY总数分别为64万、33万和1166万。全球范围内年龄标准化发病率（ASIR）、年龄标准化死亡率（ASDR）和年龄标准化DALY率呈下降趋势，而在高社会人口指数（SDI）地区ASIR呈上升趋势。男性的白血病负担比女性更重。按病因分类，急性髓系白血病（AML）、慢性髓系白血病（CML）和慢性淋巴细胞白血病（CLL）更容易给老年人带来负担，而急性淋巴细胞白血病（ALL）对年轻人群的影响更大。观察到SDI与ASIR中的AAPC之间存在显著正相关，而SDI与ASDR和年龄标准化DALY率中的AAPC均呈负相关。吸烟仍然是与白血病相关死亡和DALY最显著的危险因素，尤其是在男性中。女性中，吸烟和高体重指数（BMI）导致的死亡和DALY相似。到2030年的未来预测估计，ASIR和ASDR将继续上升，而DALY率预计将下降。