Cancer Causes & Control

, Volume 29, Issue 3, pp 379–382 | Cite as

Challenges in assessing the real incidence of chronic lymphocytic leukemia: 16 years of epidemiological data from the province of Girona, Spain

  • Marta Solans
  • Gemma Osca-Gelis
  • Raquel Comas
  • Josep Maria Roncero
  • David Gallardo
  • Rafael Marcos-Gragera
  • Marc Saez
Brief report


Determining chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) incidence is challenging for two reasons: cancer registries tend to underreport CLL cases and its diagnostic criteria changed markedly in 2008. No studies have reported incidence rates dealing with both difficulties, and thus CLL/SLL burden in Europe is currently uncertain. Herein, we present accurate CLL/SLL incidence in a Spanish region during 1998–2013, using the population-based Girona Cancer Registry (GCR). We detected an 18.2% under-reporting of CLL/SLL cases when combining records from the GCR and additional information sources (i.e., records of flow cytometry laboratories, hospital registries and hematologists’ databases). In addition, age-adjusted rates (using the 2013 European population) changed from 7.57 (95% CI 6.87; 8.30) in 1998–2008 to 6.35 (95% CI 5.51; 7.30) in 2009–2013. Overall, completeness of CLL/SLL data requires accurate diagnosis and reporting of cases. Revision of cancer registry operations to include CLL/SLL-specific surveillance is likely to ensure that the monitoring of this malignancy is entirely accurate.


Chronic lymphocytic leukemia Incidence Under-reporting 2008 Guidelines Cancer registry 



This work was supported by a grant from the Spanish Ministry of Health (FIS PI15/00966) and by CIBERESP (PhD contract to MS).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)Carlos III Institute of HealthMadridSpain
  2. 2.Research Group on Statistics, Econometrics and Health (GRECS)University of GironaGironaSpain
  3. 3.Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of CataloniaCatalan Institute of OncologyGironaSpain
  4. 4.Haematological Service, University Hospital Dr. Josep Trueta, Catalan Institute of OncologyGironaSpain

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