Deakin Health Economics, Deakin University School of Health and Social Development, Burwood, Victoria, Australia
School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.
BMJ Open. 2024 Nov 27;14(11):e084943. doi: 10.1136/bmjopen-2024-084943.
Leukaemias and lymphomas are among the most prevalent and significant cancers in Australasia and Oceania. This study aims to examine the burden of leukaemias/lymphomas and its temporal trend in Australasia and Oceania from 2010 to 2019.
Epidemiological study METHODS: Data from the Global Burden of Disease (GBD) 2019 were used to examine the burden of leukaemia/lymphoma key subtypes (acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), Hodgkin-lymphoma (HL) and non-Hodgkin's lymphoma (NHL)) by sex and 5 year age groups (from <5 years to 85 years+), in terms of incidence, prevalence, disability-adjusted life years (DALYs) and deaths. Estimated average percentage changes were calculated to assess the temporal trends of leukaemia/lymphoma burden (incidence/prevalence/DALYs/deaths) from 2010 to 2019 in Australasia and Oceania.
AML and NHL were the leading causes of leukaemia/lymphoma burden in both regions. Age-standardised rates (ASRs) for AML versus NHL in Australasia were: incidence 4.72 versus 19.06, DALYs 89.01 versus 161.68 and deaths 4.15 versus 8.02 per 100 000 population. ASRs for AML versus NHL in Oceania were: incidence 1.36 versus 1.08, DALYs 49.16 versus 38.30 and deaths 0.91 versus 0.98 per 100 000 population. From 2010 to 2019, Australasia observed an increasing trend in incidence/prevalence/deaths across most leukaemias/lymphomas and increasing/stable trend in DALYs for AML/CLL/NHL, while Oceania observed increasing trends in incidence/prevalence/DALYs for CLL/NHL and stable trends in all outcomes (except for prevalence (stable)) for AML. Contrasting mortality trends for ALL/CML/HL were observed between the two regions (increasing/stable in Australasia and decreasing in Oceania). Statistically significant differences were observed in disease burden trends between sexes, with males experiencing a greater increase (or smaller decrease) in the burden for AML in both regions.
Different temporal trends in leukaemia/lymphoma burden observed in two closely situated geographic regions with different sociodemographic indices highlight the necessity for region-specific intervention strategies to enhance the access to innovative disease treatments, reducing leukaemia/lymphoma burden.
白血病和淋巴瘤是澳大拉西亚和大洋洲最常见和最严重的癌症之一。本研究旨在探讨 2010 年至 2019 年期间澳大拉西亚和大洋洲白血病/淋巴瘤的负担及其时间趋势。
流行病学研究
使用 2019 年全球疾病负担（GBD）的数据，按性别和 5 岁年龄组（<5 岁至 85 岁以上），检查白血病/淋巴瘤关键亚型（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）、霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL））的负担，包括发病率、患病率、残疾调整生命年（DALYs）和死亡人数。计算估计的平均百分比变化，以评估 2010 年至 2019 年期间澳大拉西亚和大洋洲白血病/淋巴瘤负担（发病率/患病率/DALYs/死亡人数）的时间趋势。
AML 和 NHL 是两个地区白血病/淋巴瘤负担的主要原因。澳大拉西亚 AML 与 NHL 的年龄标准化率（ASR）分别为：发病率 4.72 比 19.06，DALYs 89.01 比 161.68，死亡人数 4.15 比 8.02/每 10 万人。在大洋洲，AML 与 NHL 的 ASR 分别为：发病率 1.36 比 1.08，DALYs 49.16 比 38.30，死亡人数 0.91 比 0.98/每 10 万人。从 2010 年至 2019 年，澳大拉西亚在大多数白血病/淋巴瘤中观察到发病率/患病率/死亡人数的上升趋势，以及 AML/CLL/NHL 的 DALYs 呈上升/稳定趋势，而大洋洲在 CLL/NHL 的发病率/患病率/DALYs 中观察到上升趋势，除 AML 的患病率（稳定）外，所有结局均呈稳定趋势。两个地区 ALL/CML/HL 的死亡率趋势存在差异（澳大拉西亚为上升/稳定，大洋洲为下降）。在疾病负担趋势方面，男女之间存在显著差异，在两个地区，AML 的负担男性增加幅度更大（或减少幅度更小）。
两个地理位置相近、社会人口指数不同的地区白血病/淋巴瘤负担的时间趋势不同，这突显了制定针对特定区域的干预策略的必要性，以提高对创新疾病治疗的可及性，从而降低白血病/淋巴瘤的负担。
