Department of Hematology, Zhejiang Cancer Hospital, Hangzhou, China.
Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Front Public Health. 2024 Aug 16;12:1425043. doi: 10.3389/fpubh.2024.1425043. eCollection 2024.
Leukemia imposes a large healthcare burden both in China and the United States (US). The disease burden differs greatly between the two countries, but related research is limited. We explored the differences in leukemia incidence and mortality between China and the US.
Data on leukemia in China and the US from 1990 to 2021 were collected from the Global Burden of Disease 2021 database. Incidence and mortality were used to estimate the disease burden, and joinpoint regression was performed to compare their secular trends. We used an age-period-cohort model to analyze the effects of age, period, and birth cohort and project future trends in the next 15 years.
In 2021, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of leukemia were lower in China than in the US. However, the incidence and mortality of acute lymphoblastic leukemia (ALL) was considerably higher in China. In the past decades, the ASIR showed decreased tendency in the US, while ASIR showed stable in China. The ASDR tended to decrease in both countries from 1990 to 2021. Males have higher rates of incidence and mortality than females in two countries. The age effects showed that children and older individuals have higher RRs for incidence and mortality in China, while the RRs for incidence and mortality in the US particularly increased in the older population. The disease burden of leukemia in children is obviously greater in China. The ASIRs and ASDRs of leukemia will continue to decline in the next 15 years in China and the US, with the US experiencing a more obvious downtrend.
Over the past decades, the ASDRs in two countries both tended to decrease. And compared to the US, China had lower leukemia incidence and mortality, However, the ASIRs in China tended toward stable, which it was showed downtrend in the US. Children have obviously greater RRs for incidence and mortality in China. The incidence and mortality will decrease continuously in two countries. Effective intervention measures are needed to reduce the burden of leukemia.
白血病在中国和美国都带来了巨大的医疗保健负担。这两个国家的疾病负担有很大差异，但相关研究有限。我们探讨了中国和美国之间白血病发病率和死亡率的差异。
从 2021 年全球疾病负担数据库中收集了 1990 年至 2021 年中国和美国的白血病数据。使用发病率和死亡率来评估疾病负担，并使用 Joinpoint 回归比较其时间趋势。我们使用年龄-时期-队列模型来分析年龄、时期和出生队列的影响，并预测未来 15 年的趋势。
2021 年，中国的标准化发病率（ASIR）和标准化死亡率（ASDR）低于美国。然而，中国的急性淋巴细胞白血病（ALL）发病率和死亡率要高得多。在过去几十年中，美国的 ASIR 呈下降趋势，而中国的 ASIR 则呈稳定趋势。从 1990 年到 2021 年，两国的 ASDR 都呈下降趋势。两国男性的发病率和死亡率均高于女性。年龄效应表明，中国儿童和老年人的发病率和死亡率的相对风险（RR）较高，而美国的 RR 则在老年人群中明显增加。中国儿童的白血病疾病负担明显更大。未来 15 年，中国和美国的白血病 ASIR 和 ASDR 将继续下降，美国的下降趋势更为明显。
过去几十年，两国的 ASDR 都呈下降趋势。与美国相比，中国的白血病发病率和死亡率较低，但中国的 ASIR 趋于稳定，而美国则呈下降趋势。中国儿童的发病率和死亡率的 RR 明显更高。两国的发病率和死亡率将持续下降。需要采取有效的干预措施来减轻白血病负担。
