Sun Kexin, Wu Hongliang, Zhu Qian, Gu Kai, Wei Hui, Wang Shaoming, Li Li, Wu Chunxiao, Chen Ru, Pang Yi, Han Bingfeng, Zeng Hongmei, Liu Meicen, Zheng Rongshou, Wei Wenqiang
National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Department of Anesthesiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
EClinicalMedicine. 2025 Apr 9;83:103193. doi: 10.1016/j.eclinm.2025.103193. eCollection 2025 May.
Haematologic malignancies accounted for 6.6% of total cancer cases and 7.2% of total cancer-related deaths worldwide in 2022. We implemented a novel approach to estimate the lifetime risk of developing and dying from various types of haematologic malignancies at the global, regional and country-specific perspectives in 2022.
We retrieved incidence and mortality rates for Hodgkin lymphoma (HL), Non-Hodgkin lymphoma (NHL), multiple myeloma (MM) and leukaemia from GLOBOCAN 2022 of 185 countries, along with the national population statistics and all-cause mortality data sourced from the United Nations. For trend analysis, we obtained consecutive cancer registry data spanning from 2003 to 2017 from the Cancer Incidence in Five Continents (CI5) Plus database. After quality control, datasets from 30 countries were included. We used the "adjusted for multiple primaries (AMP)" method to calculate the lifetime risk of incidence (LRI) and mortality (LRM) by cancer type, selected age interval, sex, country and geographic region.
In 2022, the global lifetime risk of incidence (LRI) and mortality (LRM) for all haematologic malignancies was 1.67% and 0.98%, respectively. LRI was highest for NHL, whereas the LRM was highest for leukaemia. On a general level, males exhibited higher LRI and LRM compared to females. Both LRI and LRM increased with higher Human Development Index (HDI) levels. The LRI and LRM for haematologic malignancies were notably high in regions such as Australia/New Zealand, Northen America, as well as Northen, Western and Southern Europe, whereas they were comparatively low in Middle, Western and Eastern Africa. We observed about 5-fold regional disparity in the LRI/LRM ratio for HL, ranging from 1.50 in Middle Africa to 7.67 in Western Europe. Individuals aged 60 and above still faced 71.26% and 78.57% remaining risks for developing and dying from all haematologic malignancies. Among the 185 countries studied, NHL was the haematologic malignancy with the highest LRI in 68.65% of the countries. However, leukaemia had the highest LRM in 58.92% of these countries. MM exhibited the highest LRI and LRM particularly in islands surrounding the Caribbean Sea. Out of 30 countries with eligible consecutive cancer surveillance data, 24 exhibited significant upward trends in LRI of all haematologic malignancies, with AAPCs ranging from 0.5% in USA to 4.3% in Latvia. 25 countries showed significant upward trends in LRM, with AAPCs ranging from 1.0% in USA to 5.5% in Republic of Korea.
The global lifetime risks of haematologic malignancies exhibit considerable variations across different world regions, necessitating country-specific and targeted decision-making strategies. In contrast to traditional indicators, the compositive lifetime risks provide intuitive measures with profound public health implications, offering fresh insights into the development of regional disease prevention and control strategies.
CAMS Innovation Funds for Medical Sciences (No. 2021-I2M-1-061, No. 2021-I2M-1-011).
2022年，血液系统恶性肿瘤占全球癌症病例总数的6.6%，占癌症相关死亡总数的7.2%。我们采用了一种新方法，从全球、区域和国家层面估计2022年罹患各类血液系统恶性肿瘤及死于这些疾病的终生风险。
我们从185个国家的GLOBOCAN 2022中检索了霍奇金淋巴瘤（HL）、非霍奇金淋巴瘤（NHL）、多发性骨髓瘤（MM）和白血病的发病率和死亡率，以及来自联合国的各国人口统计数据和全因死亡率数据。对于趋势分析，我们从《五大洲癌症发病率》（CI5）Plus数据库中获取了2003年至2017年连续的癌症登记数据。经过质量控制后，纳入了30个国家的数据集。我们使用“多原发调整（AMP）”方法，按癌症类型、选定的年龄区间、性别、国家和地理区域计算发病终生风险（LRI）和死亡终生风险（LRM）。
2022年，所有血液系统恶性肿瘤的全球发病终生风险（LRI）和死亡终生风险（LRM）分别为1.67%和0.98%。NHL的LRI最高，而白血病的LRM最高。总体而言，男性的LRI和LRM高于女性。LRI和LRM均随人类发展指数（HDI）水平的升高而增加。血液系统恶性肿瘤的LRI和LRM在澳大利亚/新西兰、北美洲以及北欧、西欧和南欧等地区显著较高，而在中东、西非和东非则相对较低。我们观察到HL的LRI/LRM比值存在约5倍的区域差异，从中非的1.50到西欧的7.67不等。60岁及以上的个体罹患所有血液系统恶性肿瘤和死于这些疾病的剩余风险仍分别为71.26%和78.57%。在研究的185个国家中，NHL在68.65%的国家中是LRI最高的血液系统恶性肿瘤。然而，白血病在这些国家中的58.92%中LRM最高。MM的LRI和LRM尤其在加勒比海周边岛屿最高。在有符合条件的连续癌症监测数据的30个国家中，24个国家所有血液系统恶性肿瘤的LRI呈显著上升趋势，年龄别发病率年度百分比变化（AAPC）范围从美国的0.5%到拉脱维亚的4.3%。25个国家的LRM呈显著上升趋势，AAPC范围从美国的1.0%到韩国的5.5%。
血液系统恶性肿瘤的全球终生风险在不同世界区域存在相当大的差异，需要制定针对具体国家的针对性决策策略。与传统指标相比，综合终生风险提供了具有深刻公共卫生意义的直观衡量标准，为制定区域疾病预防和控制策略提供了新的见解。
中国医学科学院医学科学创新基金（编号2021-I2M-1-061、编号2021-I2M-1-011）。
Zotero 插件
