Call T G, Noël P, Habermann T M, Beard C M, O'Fallon W M, Kurland L T
Division of Hematology and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905.
Mayo Clin Proc. 1994 Apr;69(4):315-22. doi: 10.1016/s0025-6196(12)62214-9.
To determine the incidence of leukemia in Olmsted County, Minnesota, for a recent 15-year period and to compare the data with reported rates for the previous 40 years.
We conducted a population study of leukemia diagnosed between 1975 and 1989 in residents of Olmsted County by review of medical records identified through diagnostic indexes, death certificates, autopsy files, and histologic preparations.
Diagnoses of leukemia were categorized into various subtypes, and age- and sex-specific incidence rates were calculated for leukemia as a whole and for each subtype. In addition, incidence rates were age- and sex-adjusted to the 1970 US white population for comparison with earlier published rates. Age and annual trends as well as sex differences were assessed with the generalized linear interactive model approach.
During 1975 through 1989, the mean annual incidence rate for leukemia was 12.3 per 100,000 population in Olmsted County. When adjusted for age and sex, the rate per 100,000 was 13.6, in comparison with a similarly adjusted rate of 11.8 for the previous decade (1965 through 1974). The rates for chronic myelogenous leukemia and acute lymphocytic leukemia remained stable throughout the entire study period; however, rates for acute myelogenous leukemia and chronic lymphocytic leukemia increased, most prominently in patients 50 years of age or older. This increased rate occurred in both males and females, but the incidence rates for both subtypes began increasing earlier for males than for females.
Although we cannot rule out an actual increase in incidence rates for these types of leukemia in the elderly population, we believe that the increase in persons older than 50 years of age reflects social change in improved health care and its better utilization by elderly persons, as well as the ability to diagnose leukemia earlier than in the past.
确定明尼苏达州奥姆斯特德县最近15年白血病的发病率，并将该数据与此前40年报告的发病率进行比较。
我们通过查阅诊断索引、死亡证明、尸检档案和组织学标本确定的病历，对奥姆斯特德县1975年至1989年期间诊断出白血病的居民进行了一项人群研究。
将白血病诊断分类为各种亚型，并计算白血病总体及各亚型的年龄和性别特异性发病率。此外，发病率按年龄和性别调整至1970年美国白人人口，以便与早期公布的发病率进行比较。采用广义线性交互模型方法评估年龄和年度趋势以及性别差异。
1975年至1989年期间，奥姆斯特德县白血病的年平均发病率为每10万人12.3例。经年龄和性别调整后，每10万人的发病率为13.6例，而前一个十年（1965年至1974年）经类似调整后的发病率为11.8例。在整个研究期间，慢性粒细胞白血病和急性淋巴细胞白血病的发病率保持稳定；然而，急性髓细胞白血病和慢性淋巴细胞白血病的发病率有所上升，在50岁及以上患者中最为明显。这种发病率上升在男性和女性中均有发生，但这两种亚型的发病率男性比女性更早开始上升。
虽然我们不能排除老年人群中这些类型白血病发病率实际上升的可能性，但我们认为50岁以上人群发病率的上升反映了社会变化，即医疗保健改善以及老年人对其更好的利用，还有比过去更早诊断白血病的能力。
