Leukemia mortality in children from Latin America: trends and predictions to 2030

J Smith Torres-Roman,Isabelle Ribeiro Barbosa,Camila Alves Dos Santos,Carlo La Vecchia,Bryan Valcarcel,Pedro Guerra-Canchari,Dyego Leandro Bezerra De Souza,Katherine A Mcglynn

doi:10.1186/s12887-020-02408-y

Abstract

BackgroundReports suggest that Latin American and Caribbean (LAC) countries have not reduced leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000–2017 and predicted mortality to 2030.MethodsWe retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013–2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.ResultsBetween 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by − 9.7%), and girls (EAPC by − 6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030.ConclusionLeukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.

Highlights

Reports suggest that Latin American and Caribbean (LAC) countries have not reduced leukemia mortality compared to high-income countries
Leukemia mortality trends were analyzed for children aged 0 to 14 years, stratified in three age groups (0–4, 5– 9, and 10–14) between 2000 and 2017
We provided an estimate of overall leukemia mortality rates in the LAC for the year 2030

Summary

Introduction

Reports suggest that Latin American and Caribbean (LAC) countries have not reduced leukemia mortality compared to high-income countries. In 2018, GLOBOCAN reported nearly 65, 000 new cases (incidence rate of 3.4 per 100,000) and approximately 30,000 deaths (mortality rate of 1.5 per 100,000) in children under 15 of age worldwide [2, 3] Both incidence and mortality are higher in boys compared to girls [1, 3]. Torres-Roman et al BMC Pediatrics (2020) 20:511 reduction), whereas among girls declined from 1.07 in 1997 to 0.70 in 2007 (35% reduction) [5] Notwithstanding these improvements, leukemia remains the leading cause of cancer mortality in Latin American and the Caribbean (LAC) children, considered as a major public health challenge in this region [9, 10]. Other factors related to increased mortality include delayed diagnosis, treatment abandonment, lack of a proper supportive care, and a shortage of pediatric oncologists as well as nurses dedicated to pediatric oncology care [13, 14]

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