Trends in disease burden of chronic myeloid leukemia at the global, regional, and national levels: a population-based epidemiologic study

Abstract

Background: Outcomes of chronic myeloid leukemia (CML) has been improved dramatically in the past two decades, but survival levels of CML patients varied in regions. Comprehensive epidemiological research is necessary to evaluate the global burden of CML.

Methods: All data used in our study came from the Global Burden of Disease (GBD) study 2017. Incidence cases, death cases, disability-adjusted life-years (DALYs), and its corresponding age-standardized rate between 1990 to 2017 were used to describe the distribution of CML burden, according to age, sex, social-demographic index (SDI), and countries. Data about attributable risk factors contributing to CML deaths and DALYs were also extracted and analyzed.

Results: Globally, the disease burden of CML gradually decreased from 1990 to 2017. Higher SDI countries achieved a remarkable effect on diminishing the CML burden. Conversely, due to population growth, the incidence cases, death cases, and DALYs of CML in lower SDI quintiles showed an upward trend. India had the most incidence cases and death cases of CML in the world. Additionally, smoking was the most significant attributable risk factor contributing to CML deaths and DALYs, followed by high body mass index.

Conclusion: The disease burden of CML decreased globally, especially in higher SDI countries in the past 28 years. The increasing incidence cases and death cases were mainly observed in lower SDI countries. Additionally, strategies to control modifiable risk factors such as smoking and high body mass index might be useful in diminishing mortality and DALYs.

Keywords: Cancer epidemiology; Chronic myeloid leukemia; Deaths; Global burden; Incidence.

Fig. 1

The global disease burden of CML in 195 countries or territories in 2017: a The incidence cases of 195 countries or territories in 2017; b the deaths of 195 countries or territories in 2017; c the DALYs of 195 countries or territories in 2017. CML, chronic myeloid leukemia; DALYs, disability-adjusted life years

Fig. 2

The age-standardized rates of CML in 195 countries or territories in 2017: a The ASIR of 195 countries or territories in 2017; b the ASDR of 195 countries or territories in 2017; c the age-standardized DALYs rate of 195 countries or territories in 2017. CML, chronic myeloid leukemia; ASIR, age-standardized incidence rate; ASDR, age-standardized death rate; DALYs, disability-adjusted life year

Fig. 3

The change trends of age-standardized rates of CML among different SDI quintiles and sex: a the ASIR from 1990 to 2017; b The ASDR from 1990 to 2017; c The age-standardized DALYs rate from 1990 to 2017. CML, chronic myeloid leukemia; ASIR, age-standardized incidence rate; ASDR, age-standardized death rate; DALYs, disability-adjusted life year; SDI, socio-demographic index

Fig. 4

The incidence cases of CML in three age groups from 1990 to 2017: a The incidence cases in the globe; b The incidence cases in the high SDI quintiles; c The incidence cases in the high-middle SDI quintiles; d The incidence cases in the middle SDI quintiles; e The incidence cases in the low-middle SDI quintiles; f The incidence cases in the low SDI quintiles. The three age groups included 15–49 years, 50–69 years, and 70 + years. SDI, socio-demographic index

Fig. 5

The correlation between EAPCs and age-standardized rate in 1990, and SDI in 2017: The correlation between EAPCs and ASIR in 1990 (a), and SDI in 2017 (b); The correlation between EAPCs and ASDR in 1990 (c), and SDI in 2017 (d); The correlation between EAPCs and age-standardized DALYs rate in 1990 (e), and SDI in 2017 (f). The circles represent 195 countries or territories and the size of circle represents the number of CML patients. ρ, Pearson’s correlation coefficient; CML, chronic myeloid leukemia; ASIR, age-standardized incidence rate; ASDR, age-standardized death rate; DALYs, disability-adjusted life year; SDI, socio-demographic index; EAPCs estimated annual percentage changes

Fig. 6

The age-standardized rates of CML deaths attributed to risk factors from 1990 to 2017 in Global (a), High SDI (b), High-middle SDI (c), Middle SDI (d), Low-middle SDI (e), Low SDI (f). CML, chronic myeloid leukemia; ASDR, age-standardized death rate; SDI, socio-demographic index