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2010-2019 年澳大拉西亚和大洋洲地区白血病和淋巴瘤负担的时间变化:2019 年全球疾病负担研究分析。

Temporal changes in the burden of leukaemia and lymphoma in the Australasia and Oceania regions, 2010-2019: an analysis of the Global Burden of Disease Study 2019.

机构信息

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.

出版信息

BMJ Open. 2024 Nov 27;14(11):e084943. doi: 10.1136/bmjopen-2024-084943.

Abstract

OBJECTIVES

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.

DESIGN

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

设计

流行病学研究

方法

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。

结果

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)。

结论

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。

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