Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
Ann Hematol. 2023 Sep;102(9):2375-2386. doi: 10.1007/s00277-023-05372-6. Epub 2023 Jul 19.
Leukemia and its subtypes impose a major public health challenge in China. Identifying the secular trend of leukemia burden is critical to facilitate optimal healthcare planning and improve the management of leukemia. The incidence rates of leukemia from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 database according to the following: subtype (acute lymphocytic leukemia [ALL], acute myeloid leukemia [AML], chronic lymphocytic leukemia [CLL], chronic myelogenous leukemia [CML], and other leukemia subtypes), sex, and age group. The average annual percentage changes and relative risks were calculated using joinpoint regression and the age-period-cohort model, respectively. The Bayesian age-period-cohort model was also applied to predict the future trend of the incidence of leukemia and its subtypes in the next 25 years. From 1990 to 2019, the age-standardized incidence rates (ASIRs) of leukemia slightly declined in males and females, which is similar to the trend of other leukemia subtypes. However, the four major leukemia subtypes, namely, ALL, AML, CLL, and CML, have been on the rise over the past three decades. The incidence rates of leukemia in children and the elderly were considerably higher than those in other age groups in males and females. Age effects were the most influential risk factor for leukemia incidence. Period effects showed that the risks of leukemia and its subtypes incidence increased with time. For cohort effects, the risks of leukemia and its subtypes were higher among the early-born cohorts compared with the late-born cohorts. The ASIRs of leukemia and its subtypes will continue to increase in the next 25 years. The burden of leukemia and its subtypes is expected to continue to increase in the next 25 years in males and females. A comprehensive understanding of the risk characteristics and disease pattern of leukemia and its subtypes is needed to formulate timely and effective intervention measures to reduce the leukemia burden in China.
在中国，白血病及其亚型构成了重大的公共卫生挑战。确定白血病负担的长期趋势对于促进最佳医疗保健规划和改善白血病管理至关重要。根据以下信息，从 2019 年全球疾病负担研究数据库中收集了 1990 年至 2019 年白血病的发病率数据：亚型（急性淋巴细胞白血病[ALL]、急性髓细胞白血病[AML]、慢性淋巴细胞白血病[CLL]、慢性髓细胞白血病[CML]和其他白血病亚型）、性别和年龄组。使用 Joinpoint 回归和年龄-时期-队列模型分别计算平均年变化百分比和相对风险。还应用贝叶斯年龄-时期-队列模型预测未来 25 年内白血病及其亚型的发病趋势。1990 年至 2019 年，男性和女性白血病的年龄标准化发病率（ASIR）略有下降，与其他白血病亚型的趋势相似。然而，在过去的三十年中，ALL、AML、CLL 和 CML 这四种主要的白血病亚型一直在上升。在男性和女性中，儿童和老年人的白血病发病率明显高于其他年龄组。年龄效应是白血病发病的最主要危险因素。时期效应表明，白血病及其亚型的发病风险随时间增加而增加。对于队列效应，与晚出生队列相比，早出生队列患白血病和其亚型的风险更高。在未来 25 年内，白血病及其亚型的 ASIR 将继续增加。在未来 25 年内，男性和女性的白血病及其亚型负担预计将继续增加。全面了解白血病及其亚型的风险特征和疾病模式，需要制定及时有效的干预措施，以减轻中国的白血病负担。
