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. 2023 May 17;13(1):82.
doi: 10.1038/s41408-023-00853-3.

Global burden of hematologic malignancies and evolution patterns over the past 30 years

Nan Zhang #  1 , Jinxian Wu #  1 , Qian Wang #  1 , Yuxing Liang  1 , Xinqi Li  1 , Guopeng Chen  1 , Linlu Ma  1 , Xiaoyan Liu  1 , Fuling Zhou  2   3
Affiliations

Global burden of hematologic malignancies and evolution patterns over the past 30 years

Nan Zhang et al. Blood Cancer J. .

Abstract

Hematologic malignancies are among the most common cancers, and understanding their incidence and death is crucial for targeting prevention, clinical practice improvement, and research resources appropriately. Here, we investigated detailed information on hematological malignancies for the period 1990-2019 from the Global Burden of Disease study. The age-standardized incidence rate (ASIR), the age-standardized death rate (ASDR), and the corresponding estimated annual percentage changes (EAPC) were calculated to assess temporal trends in 204 countries and territories over the past 30 years. Globally, incident cases of hematologic malignancies have been increasing since 1990, reaching 1343.85 thousand in 2019, but the ASDR for all types of hematologic malignancies has been declining. The ASDR for leukemia, multiple myeloma, non-Hodgkin lymphoma, and Hodgkin lymphoma were 4.26, 1.42, 3.19, and 0.34 per 100,000 population in 2019, respectively, with Hodgkin lymphoma showing the most significant decline. However, the trend varies by gender, age, region, and the country's economic situation. The burden of hematologic malignancies is generally higher in men, and this gender gap decreases after peaking at a given age. The regions with the largest increasing trend in the ASIR of leukemia, multiple myeloma, non-Hodgkin lymphoma, and Hodgkin lymphoma were Central Europe, Eastern Europe, East Asia, and Caribbean, respectively. In addition, the proportion of deaths attributed to high body-mass index continued to rise across regions, especially in regions with high socio-demographic indices (SDI). Meanwhile, the burden of leukemia from occupational exposure to benzene and formaldehyde was more widespread in areas with low SDI. Thus, hematologic malignancies remain the leading cause of the global tumor burden, with growing absolute numbers but sharp among several age-standardized measures over the past three decades. The results of the study will inform analysis of trends in the global burden of disease for specific hematologic malignancies and develop appropriate policies for these modifiable risks.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Global trends in incidence and death for hematological malignancies from 1990 to 2019.
A The new cases of hematological malignancies from 1990 to 2019. B The number of deaths due to hematological malignancies from 1990 to 2019. C ASIR and EAPC in hematological malignancies over the last 30 years. D ASDR and EAPC in hematological malignancies over the last 30 years. E The proportion of new cases of hematological malignancies from 1990 to 2019. F The proportion of deaths of hematological malignancies from 1990 to 2019. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change, FISH fluorescence in situ hybridization, mPCR multiplex polymerase chain reaction, ELISA enzyme-linked immunosorbent assay, FCM flow cytometry, IHC immunohistochemical, NGS Next-generation sequencing, MS mass spectrum, ctDNA circulating tumor DNA, WHO World Health Organization, IMWG International Myeloma Working Group, REAL Revised European American Lymphoma, CHOP cyclophosphamide, doxorubicin, vincristine, and prednisone.
Fig. 2
Fig. 2. Global incidence and death of hematological malignancies by age and sex.
A Global hematological malignancies incidence rates by age for both sexes combined in 1990 and 2019. B Global hematological malignancies deaths by age for both sexes combined in 1990 and 2019. For each group, the below column shows case data in 1990 and the above column shows data in 2019. C The sex ratio of hematological malignancies incident cases from 1990 to 2019 by four causes. D The sex ratio of hematological malignancies deaths from 1990 to 2019 by four causes. E The ratio of male to female in global hematological malignancies incident cases by age in 1990 and 2019. F The ratio of male to female in global hematological malignancies deaths by age in 1990 and 2019.
Fig. 3
Fig. 3. The global trends in leukemia by five subtypes and regions.
A The ASIR of leukemia at a regional level in 1990 and 2019. B The ASDR of leukemia at a regional level in 1990 and 2019. C The EAPC in ASIR of leukemia from 1990 to 2019, by subtypes and by regions, for both sexes, combined. D The EAPC in ASDR of leukemia from 1990 to 2019, by subtypes and by regions, for both sexes, combined. Blue indicates a downward trend and Red indicates an upward trend. AML acute myeloid leukemia, ALL acute lymphoid leukemia, CML chronic myeloid leukemia, CLL chronic lymphoid leukemia, ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
Fig. 4
Fig. 4. The global trends of leukemia by countries and territories.
A The ASIR of leukemia in 2019. B The EAPC in ASIR of leukemia from 1990 to 2019. C The ASDR of leukemia in 2019. D The EAPC in ASDR of leukemia from 1990 to 2019. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
Fig. 5
Fig. 5. The global trends in multiple myeloma by regions.
A The ASIR of multiple myeloma at a regional level in 1990 and 2019. B The EAPC in ASIR of multiple myeloma from 1990 to 2019 by region, for both sexes, combined. C The ASDR of multiple myeloma at a regional level in 1990 and 2019. D The EAPC in ASDR of multiple myeloma from 1990 to 2019 by region, for both sexes, combined. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
Fig. 6
Fig. 6. The global trends of multiple myeloma by countries and territories.
A The ASIR of multiple myeloma in 2019. B The EAPC in ASIR of multiple myeloma from 1990 to 2019. C The ASDR of multiple myeloma in 2019. D The EAPC in ASDR of multiple myeloma from 1990 to 2019. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
Fig. 7
Fig. 7. The global trends in lymphoma by regions.
A The ASIR of non-Hodgkin lymphoma and Hodgkin lymphoma at a regional level in 1990 and 2019. B The ASDR of non-Hodgkin lymphoma and Hodgkin lymphoma at a regional level in 1990 and 2019. C The EAPC in ASIR of non-Hodgkin lymphoma and Hodgkin lymphoma from 1990 to 2019 by regions, for both sexes, combined. D The EAPC in ASDR of non-Hodgkin lymphoma and Hodgkin lymphoma from 1990 to 2019 by regions, for both sexes, combined. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
Fig. 8
Fig. 8. The global trends of Non-Hodgkin lymphoma by countries and territories.
A The ASIR of Non-Hodgkin lymphoma in 2019. B The EAPC in ASIR of Non-Hodgkin lymphoma from 1990 to 2019. C The ASDR of Non-Hodgkin lymphoma in 2019. D The EAPC in ASDR of Non-Hodgkin lymphoma from 1990 to 2019. ASIR age-standardized incidence rate, ASDR age-standardized death rate, EAPC estimated annual percentage change.
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