Abstract
Leukemia is one of the most common cancers. We conducted this study to comprehensively analyze the temporal trends of leukemia mortality during 2003–2017 and project the trends until 2030. We extracted national-level data on annual leukemia mortality from China Health Statistics Yearbooks (2003–2017). We applied the Joinpoint regression model to assess leukemia mortality trends in urban and rural China by sex during 2003–2017. We also produced sex-specific leukemia mortality using the adjusted Global Burden Disease (GBD) 2016 projection model. In urban areas, age-standardized leukemia mortality decreased significantly among females during 2003–2017 (APC = −0.9%; 95% CI: −1.7, −0.1%). In rural areas, significant decreases of age-standardized leukemia mortality were both found among males (APC = −1.7%; 95% CI: −2.9, −0.5%) and females (APC = −1.6%; 95% CI: −2.6, −0.7%) from 2008 to 2017. Rural-urban and sex disparities of leukemia mortality will continue to exist until the year 2030. According to projection, the leukemia mortality rates of males and rural populations are higher than that of females and urban populations. In 2030, leukemia mortality is projected to decrease to 3.03/100,000 and 3.33/100,000 among the males in urban and rural areas, respectively. In females, leukemia mortality will decrease to 1.87/100,000 and 2.26/100,000 among urban and rural areas, respectively. Our study suggests that more precautionary measures to reduce leukemia mortality are need, and more attention should be paid to rural residents and males in primary prevention of leukemia in China.
Highlights
Leukemia, known as leukemia, is a group of blood cancers that start in blood-forming tissues and result in large numbers of abnormal blood cells in the bloodstream
Leukemia is closely related to ionizing radiation, benzene, formaldehyde, pesticides and infectious agents [7], and rural residents are more likely to expose to these risk factors, which could lead to the rise of leukemia mortality in rural areas and the enlarging rural-urban disparities for leukemia mortality
We extracted age-specific crude mortality rates of leukemia by year from China Health Statistics Yearbooks (2003–2017), which cover disease-specific mortality stratified by age and sex in urban and rural populations
Summary
Known as leukemia, is a group of blood cancers that start in blood-forming tissues and result in large numbers of abnormal blood cells in the bloodstream. Sex disparities are observed in leukemia mortality. It is necessary to examine the trends of leukemia mortality by sex and area in China to provide positive implications for policy-makers in their attempt to reduce health inequities related to leukemia. Previous studies have reported leukemia mortality trends in China, they either covered a small proportion of the Chinese population in some certain cities such as Tianjin [9] and Kunshan [10], or no updated data were provided [11]. Large-scale nationwide epidemiological study of leukemia mortality trends with the latest data in China is needed. We examined rural-urban and sex disparities in leukemia mortality. Key findings reported in this paper will be critically important for policy-makers in China to develop appropriate and effective prevention and treatment of leukemia, which will further contribute to achieving “leaving no one behind” (a key SDGs pledge) [12]
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