中国与美国1990年至2021年白血病的年代趋势比较及未来15年的预测

Comparison of secular trends of leukemia in China and the United States from 1990 to 2021 and their projections for the next 15 years

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FRONTIERS IN PUBLIC HEALTH

影响因子:3.4

分区:医学3区 / 公共卫生3区

发表日期:2024

作者: Xinyi Ge, Lifei Zhang, Qiaolei Zhang, Jianhua Feng, Linlin Yang, Yuxin Tong, Shan Zheng, Yamin Tan

DOI: 10.3389/fpubh.2024.1425043

摘要

白血病在中国和美国均带来巨大的医疗负担，两国的疾病负担差异显著，但相关研究有限。本研究比较了两国白血病的发病率和死亡率的差异。数据来源于“全球疾病负担2021”数据库，涵盖1990年至2021年。利用发病率和死亡率估算疾病负担，进行趋势分析的Joinpoint回归，并采用年龄-时期-队列模型分析年龄、时期和出生队列的影响，预测未来15年的趋势。结果显示，2021年，中国的白血病年龄标准化发病率（ASIR）和死亡率（ASDR）均低于美国，但急性淋巴细胞白血病（ALL）的发病率和死亡率在中国显著高于美国。过去几十年，美国的ASIR呈下降趋势，而中国则趋于稳定。两国的ASDR自1990年以来均呈下降趋势。男性的发病率和死亡率均高于女性。中国儿童和老年人RR（相对风险）较高，尤其在老年群体中RR明显增加。中国儿童白血病的疾病负担明显大于美国。未来15年，两个国家的白血病ASIR和ASDR将持续下降，美国的下降趋势更为明显。总体来看，两个国家的ASDR均呈下降趋势。中国的白血病发病率和死亡率较低，但ASIR趋于稳定，而美国则出现下降。中国儿童的RR明显高于其他年龄段。未来两国的发病率和死亡率都将持续下降。有效干预措施对于减轻白血病负担具有重要意义。

Abstract

Leukemia imposes a large healthcare burden both in China and the United States (US). The disease burden differs greatly between the two countries, but related research is limited. We explored the differences in leukemia incidence and mortality between China and the US.Data on leukemia in China and the US from 1990 to 2021 were collected from the Global Burden of Disease 2021 database. Incidence and mortality were used to estimate the disease burden, and joinpoint regression was performed to compare their secular trends. We used an age-period-cohort model to analyze the effects of age, period, and birth cohort and project future trends in the next 15 years.In 2021, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of leukemia were lower in China than in the US. However, the incidence and mortality of acute lymphoblastic leukemia (ALL) was considerably higher in China. In the past decades, the ASIR showed decreased tendency in the US, while ASIR showed stable in China. The ASDR tended to decrease in both countries from 1990 to 2021. Males have higher rates of incidence and mortality than females in two countries. The age effects showed that children and older individuals have higher RRs for incidence and mortality in China, while the RRs for incidence and mortality in the US particularly increased in the older population. The disease burden of leukemia in children is obviously greater in China. The ASIRs and ASDRs of leukemia will continue to decline in the next 15 years in China and the US, with the US experiencing a more obvious downtrend.Over the past decades, the ASDRs in two countries both tended to decrease. And compared to the US, China had lower leukemia incidence and mortality, However, the ASIRs in China tended toward stable, which it was showed downtrend in the US. Children have obviously greater RRs for incidence and mortality in China. The incidence and mortality will decrease continuously in two countries. Effective intervention measures are needed to reduce the burden of leukemia.