Leukemia incidence trends at the global, regional, and national level between 1990 and 2017
Leukemia incidence trends at the global, regional, and national level between 1990 and 2017
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DOI：
10.1186/s40164-020-00170-6
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发表时间：
2020-06-19
影响因子：
10.9
通讯作者：
Wang, Qi
中科院分区：
文献类型：
--
作者：
Dong, Ying;Shi, Oumin;Wang, Qi
白血病是一组危及生命的血液和骨髓恶性疾病。白血病的发病率因病理类型和不同人群而异。方法我们从全球疾病负担在线数据库中检索了按性别、年龄、地点、日历年和类型分类的白血病发病率数据。估计平均百分比变化（EAPC）用于量化1990年至2017年白血病年龄标准化发病率（ASIR）的趋势。结果在全球范围内，虽然新诊断的白血病病例数从1990年的35.45万增加到2017年的51.85万，但ASIR每年下降0.43%。全球急性淋巴细胞白血病（ALL）病例数从1990年的4.91万例增加到2017年的6.42万例，而ASIR则有所下降（EAPC = - 0.08，95% CI - 0.15，- 0.02）。在1990年至2017年期间，分别有55、29和111个国家或地区的急性淋巴细胞白血病发病率显著上升、保持稳定和显著下降。慢性淋巴细胞白血病（CLL）病例在1990年至2017年期间增加了两倍多。从1990年到2017年，CLL的ASIR每年增长0.46%。超过85%的国家的CLL ASIR有所增加。1990年，急性髓系白血病（AML）占全球白血病病例总数的18.0%。这一比例在2017年增加到23.1%。AML的ASIR从1.35/100，000增加至1.54/100，000，EAPC为0.56（95% CI 0.49，0.62）。总共有127个国家或地区的反洗钱报告显著增加。慢性粒细胞白血病（CML）病例数从1990年的3.18万例增加到2017年的3.42万例。CML的ASIR从0.75/10万下降到0.43/10万。共有141个国家或地区的慢粒ASIR下降。结论1990年至2017年期间，白血病发病率显著下降。然而，在同一时期，AML和CLL的发病率在大多数国家显著增加，这表明这两种类型的白血病可能成为一个主要的全球公共卫生问题。
Background Leukemias are a group of life-threatening malignant disorders of the blood and bone marrow. The incidence of leukemia varies by pathological types and among different populations. Methods We retrieved the incidence data for leukemia by sex, age, location, calendar year, and type from the Global Burden of Disease online database. The estimated average percentage change (EAPC) was used to quantify the trends of the age-standardized incidence rate (ASIR) of leukemia from 1990 to 2017. Results Globally, while the number of newly diagnosed leukemia cases increased from 354.5 thousand in 1990 to 518.5 thousand in 2017, the ASIR decreased by 0.43% per year. The number of acute lymphoblastic leukemia (ALL) cases worldwide increased from 49.1 thousand in 1990 to 64.2 thousand in 2017, whereas the ASIR experienced a decrease (EAPC = - 0.08, 95% CI - 0.15, - 0.02). Between 1990 and 2017, there were 55, 29, and 111 countries or territories that experienced a significant increase, remained stable, and experienced a significant decrease in ASIR of ALL, respectively. The case of chronic lymphocytic leukemia (CLL) has increased more than twice between 1990 and 2017. The ASIR of CLL increased by 0.46% per year from 1990 to 2017. More than 85% of all countries saw an increase in ASIR of CLL. In 1990, acute myeloid leukemia (AML) accounted for 18.0% of the total leukemia cases worldwide. This proportion increased to 23.1% in 2017. The ASIR of AML increased from 1.35/100,000 to 1.54/100,000, with an EAPC of 0.56 (95% CI 0.49, 0.62). A total of 127 countries or territories experienced a significant increase in the ASIR of AML. The number of chronic myeloid leukemia (CML) cases increased from 31.8 thousand in 1990 to 34.2 thousand in 2017. The ASIR of CML decreased from 0.75/100,000 to 0.43/100,000. A total of 141 countries or territories saw a decrease in ASIR of CML. Conclusions A significant decrease in leukemia incidence was observed between 1990 and 2017. However, in the same period, the incidence rates of AML and CLL significantly increased in most countries, suggesting that both types of leukemia might become a major global public health concern.