Abstract
Developing countries have a younger population of CML patients than developed countries. Patterns of age at diagnosis and incidence by geography and gross national income (GNI) are not well understood. A population-based descriptive study was conducted using data from the International Agency for Research on Cancer’s population-based registry compilation. Geographical regions were classified according to the United Nations World Macro Regions and Components. Age-Standardized Incidence Rates (ASR) were adjusted to the World Standard Population. Poisson regression was used to assess age-specific interactions. 57.2 % were male among 33,690 diagnoses. Median age at diagnosis was lowest in Africa and Asia (47 years) and highest in Oceania (72 years). ASR was lowest in African males (0.61 per 100,000) and Asian females (0.55 per 100,000) and highest in Oceania males and females (1.78 and 0.96 per 100,000, respectively). A significant interaction (p < 0.0001) between age (<50 years and >50 years) and region exists; no significant differences were seen by region in the <50 age-group while significant differences by region exist in the >50 age group. Population-based estimates suggest that the median age at diagnosis and incidence varies by region. Geographic and income heterogeneity suggest an important effect of environment that warrants further studies.
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References
Sawyers C. Chronic myeloid leukemia. N Engl J Med. 1999;340(7):1330–40.
Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, Boyle P. Cancer incidence in five continents, Vol. IX. Lyon, IARC: IARC Scientific Publications No. 160; 2007.
Rohrbacher M, Hasford J. Epidemiology of chronic myeloid leukaemia (CML). Best Pract Res Clin Haematol. 2009;22:295–302.
Au WY, Caguioa PB, Chuah C, Hsu SC, Jootar S, Kim D-W, Kweon I-Y, O’Neil WM, Saikia TK, Wang J. Chronic myeloid leukemia in Asia. Int J Hematol. 2009;89:14–23.
Heyssel R, Brill AB, Woodbury LA, Nishimura ET, Ghose T, Hoshino T, Yamasaki M. Leukemia in Hiroshima atomic bomb survivors. Blood. 1960;15(3):313–31.
Mendizabal AM, Garcia-Gonzalez P, Levine PH. Regional variations in age at diagnosis and overall survival among patients with chronic myeloid leukemia from low and middle income countries. Cancer Epidemiol. 2013;37(3):247–54.
Tekinturhan E, Audureau E, Tavolacci M-P, Garcia-Gonzalez P, Ladner J, Saba J. Improving access to care in low and middle-income countries: institutional factors related to enrollment and patient outcome in a cancer drug access program. BMC Health Serv Res. 2013;13:304–13.
United Nations World Macro Regions and Components. http://unstats.un.org/unsd/methods/m49/m49regin.htm.
World Bank Gross National Income per Capita. http://data.worldbank.org/indicator/NY.GNP.PCAP.CD.
Howlander N, Noone A, Krapcho M, Neyman N, Aminou R, Altekruse S, Kosary C, Ruhl J, Tatalovich Z, Cho H et al: SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). In: National Cancer Institute. vol. Bethesda, MS, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, 2012.
Anderson WF, Chatterjee N, Ershler W, Brawley O. Estrogen receptor breast cancer phenotypes in the surveillance, epidemiology and end results database. Breast Cancer Res Treat. 2002;76(1):27–36.
Scott DW: Multivariate Density Estimation. Theory, Practice and Visualization. New York; 1992.
Jones MC, Marron JS, Sheather SJ. A brief survey of bandwidth selection for density estimation. J Am Stat Assoc. 1996;91(433):401–7.
Klein RJ, Schoenborn CA: Age Adjustment Using the 2000 Projected U.S. Population. Healthy People 2010 statistical notes: no 20. In. Hyattsville, Maryland: National Center for Health Statistics; 2001.
Blair A, Fraumeni J, Mason T. Geographic patterns of leukemia in the United States. J Chronic Dis. 1980;33(4):251–60.
Blair A, White D. Death certificate study of leukemia among farmers from Wisconsin. J Natl Cancer Inst. 1981;66(6):1027–30.
Bonner MR, Williams BA, Rusiecki JA, Blair A, Beane Freeman LE, Hoppin JA, Dosemeci M, Lubin J, Sandler DP, Alavanja MCR. Occupational exposure to terbufos and the incidence of cancer in the Agricultural Health Study. Cancer Causes Control. 2010;21:871–7.
Van Maele-Fabry G, Duhayon S, Lison D. A systematic review of myeloid leukemias and occupational pesticide exposure. Cancer Causes Control. 2007;18:457–78.
Deininger MWN, Druker BJ. Specific targeted therapy of chronic myelogenous leukemia with imatinib. Pharmacol Rev. 2003;55(3):401–23.
Malhotra P, Varma S. Chronic myeloid leukaemia in India. Lancet. 2007;370:1127.
Hehlmann R, Hochhaus A, Baccarani M. LeukemiaNet obotE: chronic myeloid leukaemia. Lancet. 2007;370:342–50.
Bhutani M, Vora A, Kumar L, Kochupillai V. Lympho-hemopoietic malignancies in India. Med Oncol. 2002;19(3):141–50.
Wang J, Huang X, Wu D, Hu J, Liu T, Hu Y, Meng F, Chen X, Hou M, Li Y, et al. Overview of chronic myelogenous leukemia and its current diagnosis and treatment patterns in 15 hospitals in China. Zhonghua Xue Ye Xue Za Zhi. 2009;30(11):721–5.
Aziz Z, Iqbal J, Akram M, Saeed S. Treatment of chronic myeloid leukemia in the imatinib era: perspective from a developing country. Cancer. 2007;109(6):1138–45.
Usmani S, Yunus S, Jamal Y. Overview of chronic myeloid leukemia patients in Pakistan in the pre-imatanib era. Asian Pac J Cancer Prev. 2009;10(6):1039–40.
Wang A-H, Wang Y-Y, Yao Y, Xu Z-Z, Zhou L, Wang L, Chen Y, Shen Z-X, Hu J, Li J-M. Summary of 615 patients of chronic myeloid leukemia in Shanghai from 2001 to 2006. J Exp Clin Cancer Res. 2010; 29(20).
India Council of Medical Research. National Cancer Registry Programme Consolidated Report of the Population Based Cancer Registries 1990–1996: Incidence and Distribution of Cancer. In. New Delhi: Indian Council of Medical Research; 2001
Aguayo A, Garcia-Alvarez E, Cazares-Ordonez Y, Crespo-Solis E, Martinez-Banos D, Guadarrama-Beltran E, Cervera-Ceballos EE, Lopez-Karpovitch X. Chronic myeloid leukemia: a clinicoepidemiologic and therapeutic description of a single institution in Mexico City. Clin Leuk. 2008;2(4):261–6.
Funke VA, Medeiro CR, Lima DH, Setubal DC, Bitencourt MA, Bonfim CM, Ruiz J, Neto JZ, Pasquini R. Therapy of chronic myeloid leukemia with imatinib mesylate in Brazil: a study of 98 cases. Revista Brasileira de Hematologia e Hemoterapia. 2005;27(3):159–65.
Luke C, Nguyen A-M, To B, Seshadri R, Hughes T, Bardy P, Colbeck M, Buranyi-Trevarton D, McMellon M, Roder D. Myeloid leukaemia treatment and survival—the South Australian experience, 1977 to 2002. Asian Pac J Cancer Prev. 2006;7:227–33.
Australian Institute of Health and Welfare (AIHW). ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW; 2012.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.
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Mendizabal, A.M., Younes, N. & Levine, P.H. Geographic and income variations in age at diagnosis and incidence of chronic myeloid leukemia. Int J Hematol 103, 70–78 (2016). https://doi.org/10.1007/s12185-015-1893-y
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DOI: https://doi.org/10.1007/s12185-015-1893-y