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2019 年全球疾病负担研究:1990-2019 年北非和中东 21 个国家和地区的白血病发病负担及其归因于危险因素的负担。

Regional and national burden of leukemia and its attributable burden to risk factors in 21 countries and territories of North Africa and Middle East, 1990-2019: results from the GBD study 2019.

机构信息

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No. 10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran.

Student Research Center Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Cancer Res Clin Oncol. 2023 Jul;149(8):4149-4161. doi: 10.1007/s00432-022-04293-7. Epub 2022 Sep 1.

Abstract

PURPOSE

Regional and national data on leukemia's burden provide a better comprehension of leukemia's trends and are vital for policy-makers for better allocation of the resources. This study reports the burden of leukemia, and the attributed burden to its risk factors in 21 countries and territories of the North Africa and Middle East.

METHODS

Data from cancer registration, scientific literature, survey, and reports were the input to estimate the burden of leukemia. In addition, the burden of attributable risk factors with evidence of causation with leukemia was calculated using the comparative risk assessment framework. All measures are reported as counts and rates divided by sex and specific age groups.

RESULTS

In 2019, there were 39,297 (95% uncertainty interval: 32,617-45,056) incident cases of leukemia with an age-standardized rate (ASR) of 7.8 (6.5-8.8) per 100,000 in the region. There were also 25,143 (21,109-28,826) deaths and 1,011,555 (822,537-1,173,621) DALYs attributed to Leukemia with an ASR of 5.4 (4.6-6.1) per 100,000 and 183.4 (150.7-211.2) per 100,000, respectively. Years of life lost (YLLs) (179.4 [147.2-206.7]) were accountable for the major part of DALYs. All count measures increased, while all the ASRs decreased during 1990-2019. The Syrian Arab Republic, Qatar, and Afghanistan had the highest ASR incidence, mortality, and DALYs rate in 2019. Incidence, DALYs, and prevalence rates were higher in males of all age groups except under five, and the highest rates were observed in +75 age group. Four major risk factors for leukemia were smoking, high body mass index, occupational exposure to benzene, and formaldehyde.

CONCLUSION

Despite the reduction in age-standardized rates of incidence and mortality, the burden of leukemia has increased steadily, due to population growth and aging. Notable variations exist between age-standardized rates in region's countries.

摘要

目的

区域和国家的白血病负担数据提供了对白血病趋势的更好理解,对政策制定者合理分配资源至关重要。本研究报告了 21 个北非和中东国家和地区的白血病负担及其危险因素的归因负担。

方法

癌症登记处、科学文献、调查和报告的数据被用来估计白血病的负担。此外,还使用比较风险评估框架计算了具有白血病因果关系证据的可归因危险因素的负担。所有措施均以性别和特定年龄组的数量和比率报告。

结果

2019 年,该地区有 39297 例(95%置信区间:32617-45056)白血病新发病例,标准化发病率(ASR)为每 100000 人 7.8(6.5-8.8)。25143 例(21109-28826)死亡和 1011555 例(822537-1173621)伤残调整生命年(DALY)归因于白血病,ASR 分别为每 100000 人 5.4(4.6-6.1)和每 100000 人 183.4(150.7-211.2)。寿命损失年(YLLs)(179.4 [147.2-206.7])占 DALY 的主要部分。1990-2019 年期间,所有计数指标均增加,而所有 ASR 均下降。2019 年,阿拉伯叙利亚共和国、卡塔尔和阿富汗的白血病发病率、死亡率和 DALY 率最高。除五岁以下儿童外,所有年龄组男性的发病率、DALY 率和患病率均较高,最高的年龄组为 75 岁以上。白血病的四个主要危险因素是吸烟、高体重指数、职业性苯和甲醛暴露。

结论

尽管发病率和死亡率的年龄标准化率有所下降,但由于人口增长和老龄化,白血病负担仍在稳步增加。该地区各国的年龄标准化率存在显著差异。

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