Godoy-Casasbuenas Natalia, Rincón Carlos Javier, Gil Fabian, Arias Nelson, Uribe Pérez Claudia, Yépez María Clara, de Vries Esther
Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Bogotá, Colombia.
Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia.
Cancer Epidemiol. 2024 Apr;89:102548. doi: 10.1016/j.canep.2024.102548. Epub 2024 Feb 29.
Childhood leukemia (CL) is the most prevalent form of pediatric cancer on a global scale. However, there is a limited understanding of the dynamics of CL incidence in South America, with a specific knowledge gap in Colombia. This study aimed to identify trends in CL incidence and to analyze the effects of age, period, and birth cohort on the risk of leukemia incidence in this population.
Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population-based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-period-cohort models addressing the identifiability issue through the application of double differences.
A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person-years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities.
This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.
儿童白血病（CL）是全球范围内最常见的儿科癌症形式。然而，人们对南美洲CL发病率的动态了解有限，哥伦比亚存在特定的知识空白。本研究旨在确定CL发病率的趋势，并分析年龄、时期和出生队列对该人群白血病发病风险的影响。
收集居住在卡利（2008 - 2017年）、布卡拉曼加（2000 - 2017年）、马尼萨莱斯（2003 - 2017年）和帕斯托（1998 - 2018年）基于人群癌症登记处服务区域内0至18岁居民中所有新诊断白血病病例（总体及按亚型）的信息。使用Joinpoint回归模型计算发病率随时间的估计年变化百分比（EAPC）以及这些EAPC斜率的潜在变化。通过应用双差分解决可识别性问题的年龄 - 时期 - 队列模型评估年龄、时期和队列对CL发病率趋势的影响。
共识别出966例儿童白血病病例。计算白血病的平均标准化发病率（ASIR），并以每10万人年表示——卡利的ASIR为4.46，布卡拉曼加为7.27，马尼萨莱斯为3.89，帕斯托为4.06。关于CL趋势，不同时期的EAPC没有统计学上的显著变化，然而，按白血病亚型分析时，则观察到ALL和AML的EAPC有统计学上的显著变化。年龄 - 时期 - 队列模型分析显示，年龄相关因素显著支撑了这四个哥伦比亚城市儿童白血病的发病趋势。
本研究为哥伦比亚四个主要城市儿童白血病的发病趋势提供了有价值的见解。分析显示不同时期总体CL发病率稳定，主要受年龄相关因素影响，且不存在队列和时期效应。这些信息对哥伦比亚CL诊断和治疗的监测及规划有用。
