DataSheet_1_Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study.pdf

BackgroundThe prognosis of chronic lymphocytic leukemia (CLL) has been improved dramatically, but there are limited studies focusing on CLL disease burden on a global scale. We aimed to evaluate the accurate assessment of the disease burden of CLL that may provide more detailed epidemiological information for rational policies.
MethodsThe main source of the data was the Global Burden of Disease (GBD) study 2019. Incident cases, death cases, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs) from 1990 to 2019 were used to describe the burden of CLL. Data about attributable risk factors were also extracted and analyzed. Bayesian age-period-cohort (BAPC) models were used to assess and project the incidence and mortality rates till 2030.
ResultsGlobally, the incidence of CLL had been increasing. Deaths and DALYs decreased slightly. The burden of death and DALY is affected by socio-demographic index (SDI). The incidence rate, death rate, and DALY rate of CLL increased significantly with age. Male-to-female ratios of incidence rates varied in different SDI quintiles. Smoking, high body mass index, and occupational exposure to benzene or formaldehyde were the potential risk factors related to CLL. Global ASIRs might tend to increase until 2030, while ASDR would decrease until 2030.
ConclusionThe disease burden of CLL decreased in higher SDI countries but increased in lower ones. Strategies for early detection of asymptomatic CLL, development of novel drugs, and measures against attributable factors should be implemented to combat CLL burden.

背景：慢性淋巴细胞白血病（chronic lymphocytic leukemia, CLL）的预后已得到显著改善，但目前针对全球范围内CLL疾病负担的研究仍较为有限。本研究旨在精准评估CLL的疾病负担，以期为制定合理的公共卫生政策提供更详实的流行病学依据。

方法：本研究的数据主要来源于2019年全球疾病负担（Global Burden of Disease, GBD）研究。我们采用1990年至2019年的新发病例数、死亡病例数、伤残调整生命年（disability-adjusted life years, DALYs）及其对应的年龄标准化率（age-standardized rates, ASRs）来刻画CLL的疾病负担情况，同时提取并分析了可归因危险因素的相关数据。本研究采用贝叶斯年龄-时期-队列（Bayesian age-period-cohort, BAPC）模型，对截至2030年的CLL发病率与死亡率进行评估与预测。

结果：全球范围内，CLL的发病率呈持续上升趋势，而死亡病例数与伤残调整生命年数则略有下降。CLL的死亡负担与伤残调整生命年负担受社会人口学指数（socio-demographic index, SDI）的影响。CLL的发病率、死亡率及伤残调整生命年率均随年龄增长而显著升高。不同社会人口学指数五分位组中，CLL发病率的男女性别比存在差异。吸烟、高体质量指数以及职业性接触苯或甲醛是与CLL相关的潜在危险因素。预计至2030年，全球年龄标准化发病率（age-standardized incidence rate, ASIRs）将持续上升，而年龄标准化死亡率（age-standardized death rate, ASDR）则会呈下降趋势。

结论：社会人口学指数较高的国家，其CLL疾病负担有所降低，而社会人口学指数较低的国家则呈上升趋势。为应对CLL的疾病负担，应采取针对无症状CLL的早期筛查策略、研发新型药物，并制定针对可归因危险因素的防控措施。