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美国慢性淋巴细胞白血病的发病率和死亡率趋势:一项基于过去四十年人口的研究。

Trends of chronic lymphocytic leukemia incidence and mortality in the United States: a population-based study over the last four decades.

作者信息

Alabrach Yousef, Mahmoud Amir A, Abdelhay Ali, Mansour Mohamad, Adra Saryia

机构信息

Medical Internship, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.

出版信息

Expert Rev Hematol. 2023 Jul-Dec;16(10):785-791. doi: 10.1080/17474086.2023.2243385. Epub 2023 Aug 1.

Abstract

BACKGROUND

Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults, and its incidence is higher in elderly individuals. This study aims to examine the burden of CLL in the United States (US) by exploring the incidence-based rates (IBR) and incidence-based mortality (IBMR) across four decades.

RESEARCH DESIGN AND METHODS

CLL incidence data were obtained from the SEER-8 registry, covering 8.3% of the US population. Cases were identified using specific diagnostic codes and excluded if diagnosed on autopsy or death certificate. Age-standardized IBR and IBMR were calculated based on age, sex, and ethnicity/race. Joinpoint Regression Program was used to analyze changing trends in incidence and mortality.

RESULTS

Since 2011, males' and females' IBRs declined by -1.72%/year ( = 0.028) and -1.07%/year ( = 0.222), respectively. IBR of patients > 75 years increased by 4.01%/year ( < 0.001) form 1998-2010, then declined by 2.02%/year ( = 0.011). IBR of Blacks increased by 0.96%/year ( < 0.001) throughout the study period. CLL IBMR stabilized at -0.38%/year ( = 0.457) since 2012. Whites' IBMR plateaued at a rate of -0.10%/year ( = 0.857) form 2012-2019, while blacks' IBMR increased by 1.40%/year ( = 0.056) between 2000-2019.

CONCLUSIONS

The analysis revealed a decline in CLL incidence since 2013, with stable mortality rates since 2012, indicating advancements in CLL management.

摘要

背景

慢性淋巴细胞白血病(CLL)是成年人中最常见的白血病,在老年人中的发病率更高。本研究旨在通过探讨四十年来基于发病率的比率(IBR)和基于发病率的死亡率(IBMR),来研究美国慢性淋巴细胞白血病的负担情况。

研究设计与方法

CLL发病率数据来自监测、流行病学和最终结果(SEER)-8登记处,覆盖美国8.3%的人口。使用特定诊断代码识别病例,若在尸检或死亡证明上确诊则予以排除。根据年龄、性别和种族/民族计算年龄标准化的IBR和IBMR。采用Joinpoint回归程序分析发病率和死亡率的变化趋势。

结果

自2011年以来,男性和女性的IBR分别以每年-1.72%(P = 0.028)和-1.07%(P = 0.222)的速度下降。1998年至2010年,75岁以上患者的IBR以每年4.01%(P < 0.001)的速度上升,随后以每年2.02%(P = 0.011)的速度下降。在整个研究期间,黑人的IBR以每年0.96%(P < 0.001)的速度上升。自2012年以来,CLL的IBMR稳定在每年-0.38%(P = 0.457)。2012年至2019年,白人的IBMR稳定在每年-0.10%(P = 0.857),而2000年至2019年,黑人的IBMR以每年1.40%(P = 0.056)的速度上升。

结论

分析显示,自2013年以来CLL发病率有所下降,自2012年以来死亡率稳定,这表明CLL管理方面取得了进展。

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