关键词: 白血病, 儿童, 疾病负担, 变化趋势, 发病率, 死亡率, 肿瘤登记

Abstract: Objective To analyze the level and trend of the disease burden of leukemia among children aged 0-14 in the Guangxi cancer registry areas from 2015 to 2019, to understand the current situation of the leukemia burden in children in Guangxi, and provide evidence for the prevention and control of childhood cancer. Methods According to the incidence and death data of childhood leukemia from 2015 to 2019 reported by Guangxi cancer registry areas, the incidence rate, the mortality rate, the age⁃standardized rate by Chinese standard population census in 2000 (ASRC) and Segi´ s world standard population (ASRW) of childhood leukemia were calculated based on gender, age, and region to assess the incidence and mortality of childhood leukemia. Furthermore, the years of life lost (YLLs), the years of lived with disability (YLDs) and the disability⁃adjusted life years (DALYs) were calculated to analyze the disease burden of childhood leukemia. The Joinpoint regression model was use to calculate the annual percentage change (APC) of childhood leukemia incidence rate and mortality, and evaluate the change trends. Results From 2015 to 2019, a total of 295 new cases of childhood leukemia were reported in the Guangxi cancer registry areas, with an incidence rate of 3.86/105, ASRC of 3.58/10⁵, ASRW of 3.93/105 (In urban areas, the incidence rate was 4.25/10⁵ and the ASRC was 3.99/105; in rural areas, the incidence rate was 3.37/10⁵ and the ASRC was 3.09/105). A total of 136 cases died of childhood leukemia were reported, with a mortality rate of 1.78/10⁵, ASRC of 1.74/10⁵, ASRW of 1.79/10⁵ (In urban areas, the mortality rate was 1.70/10⁵ and the ASRC was 1.70/105; in rural areas, the mortality rate was 1.87/10⁵ and the ASRC was 1.79/10⁵). From 2015 to 2019, the incidence rate of childhood leukemia in the Guangxi cancer registry areas showed a downward trend (APC=-5.79%, P=0.29), but the change was not statistically significant. However, the downward change of mortality was significant (APC=-9.95%, P=0.03). The trends of incidence and mortality rates of leukemia in male and female children were generally consistent with the overall trend. The DALYs caused by leukemia in children aged 0-14 years old were 4,255.48 person⁃years, with a DALYs rate of 55.65/105, among which the DALYs rate was 63.86/105 in the group aged 0-4 years and 51.14/10⁵ in the group aged 5-14 years.The incidence rate, mortality and DALYs of leukemia in male children were higher than those in female children. Conclusions From 2015 to 2019, the incidence rate, mortality and DALYs rate of childhood leukemia in the Guangxi cancer registry area showed a general downward trend. The disease burden of leukemia in male children are higher than those in female, and in the rural areas are higher than in the urban areas. The focus of concern should be on children aged 0-4 years.

Key words: Leukemia, Children, Disease burden, Change trend, Incidence, Mortality, Cancer registry