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1990-2019 年国家和次国家白血病负担及其危险因素:来自 2019 年全球疾病负担研究的结果。

National and subnational burden of leukemia and its risk factors, 1990-2019: Results from the Global Burden of Disease study 2019.

机构信息

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

出版信息

PLoS One. 2023 Nov 30;18(11):e0287917. doi: 10.1371/journal.pone.0287917. eCollection 2023.

Abstract

BACKGROUND

Hematologic malignancies have a great essential role in cancer global burden. Leukemia which two major subtypes based on the onset, is one of the common subtypes of this malignancy.

METHOD

For the GBD 2019 study, cancer registry data and vital registration system were used to estimate leukemia mortality. The Meta-Regression-Bayesian Regularized Trimmed (MR-BRT), Cause of Death Ensemble model (CODEm) and Spatiotemporal Gaussian Process Regression (ST-GPR) were used to model our data and estimate each quantity of interest. Mortality to incidence ratios (MIR) were used to generate incidence and survival from mortality rate. Prevalence and survival were used to generate years lived with disability (YLDs). Age-specific mortality and life expectancy at the same age were used to estimate years of life lost (YLLs). The sum of YLLs and YLDs generates DALYs.

RESULTS

The total national incidence of leukemia increased from 6092 (UI 95%: 3803-8507) in 1990 to 6767 (4646-7890) new cases in 2019. However, leukemia age-standardized incidence ratio(ASIR) decreased from 11.6 (8-14.8) to 8.9 (6.2-10.3) new cases per 100,000 in this exact period. At the national level, deaths from leukemia increased 1.5-fold between 1990 and 2019, from 3287 (2284-4201) to 4424 (3137-5030), whereas the age-standardized death rate(ASDR) decreased from 8.3 (6.1-9.8) in 1990 to 6 (4.3-6.8) per 100,000 in 2019. In the study period, total leukemia DALYs decreased 12.2% and reached 162850 (110681-188806), in 2019. The age-standardized DALYs decreased 36.7% from 324.3 (224.8-413.4) in 1990 to 205.3 (140.3-237.8) in 2019. ASDR, DALYs, YLLs, and YLDs rate to high BMI was increasing while smoking and occupational exposure to benzene and formaldehyde were decreasing in the study period.

CONCLUSION

This study provided a better understanding of leukemia burden and to reduce controversies of leukemia across Iran. The leukemia status alteration of the country, is trackable.

摘要

背景

血液系统恶性肿瘤在全球癌症负担中具有重要作用。白血病根据发病时间分为两种主要亚型,是这种恶性肿瘤的常见亚型之一。

方法

在 GBD 2019 研究中,利用癌症登记数据和生命登记系统来估计白血病死亡率。使用回归贝叶斯正则化修剪 (MR-BRT)、死因综合模型 (CODEm) 和时空高斯过程回归 (ST-GPR) 对数据进行建模,并估计每个感兴趣的数量。死亡率与发病率的比值 (MIR) 用于从死亡率生成发病率和生存率。患病率和生存率用于生成伤残生命年 (YLDs)。特定年龄的死亡率和同一年龄的预期寿命用于估计生命损失年 (YLLs)。YLLs 和 YLDs 的总和生成残疾调整生命年 (DALYs)。

结果

1990 年全国白血病总发病率为 6092 例(95%UI:3803-8507),2019 年增加至 6767 例(4646-7890)。然而,在此期间,白血病年龄标准化发病率(ASIR)从 11.6(8-14.8)降至 8.9(6.2-10.3)每 10 万人新发病例。在全国范围内,白血病死亡人数在 1990 年至 2019 年期间增加了 1.5 倍,从 3287 例(2284-4201)增加至 4424 例(3137-5030),而年龄标准化死亡率(ASDR)从 1990 年的 8.3(6.1-9.8)降至 2019 年的 6(4.3-6.8)每 10 万人。在研究期间,白血病总 DALYs 减少了 12.2%,至 2019 年的 162850(110681-188806)。年龄标准化 DALYs 从 1990 年的 324.3(224.8-413.4)下降到 2019 年的 205.3(140.3-237.8)。在研究期间,高 BMI、吸烟和职业性接触苯和甲醛的 ASDR、DALYs、YLLs 和 YLDs 率呈上升趋势。

结论

本研究更深入地了解了白血病负担,并减少了伊朗各地对白血病的争议。该国的白血病状况变化是可以追踪的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a94/10688854/f4eab9fa7612/pone.0287917.g001.jpg

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