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      Trend Analysis of Leukemia Mortality and Years of Life Lost (YLL) from 2004 to 2019 in the Fars Province, Iran

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          Abstract

          Background:

          Although the incidence of leukemia’s is not high, many of these cancers lead to death over a short period. This is a cross-sectional study on leukemia deaths in southern Iran.

          Methods:

          All deaths due to leukemia in the Fars province were obtained from the population-based electronic death registration system (EDRS). Crude and age-standardized mortality rate (ASMR), YLL, and YLL rate data were calculated, and joinpoint regression was used to examine the trend.

          Results:

          Totally, 3141 deaths from leukemia occurred in the Fars province during the study period (2004-2019). Of these, 61.5% (1933 cases) pertained to men. The crude mortality rate was 6.1 (95% CI: 5.8 to 6.4) in men and 3.9 (95% CI: 3.7 to 4.2) in women. Also, ASMR was 6.6 (95% CI: 6.3 to 6.9) and 4.2 (95% CI: 4.0 to 4.4) in men and women, respectively. The total YLLs due to leukemia were 32804 in men and 23064 in women. The joinpoint regression analysis demonstrated that the trend of YLL rate due to premature mortality was stable: the annual percent change (APC) was -1.2% (95% CI: -2.5 to 0.2, P=0.090) for males, and -1.0% (95% CI: -2.9 to 0.9, P=0.274) for females.

          Conclusion:

          The mortality and YLL due to leukemia had a stable trend. However, this trend has been decreasing or increasing in some age groups. Determining and controlling essential risk factors, especially the environmental factors of leukemia, may reduce its burden in the Fars province.

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

            Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
            This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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              Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

              Christina Fitzmaurice, Christine Allen, Ryan M Barber … (2017)
              IMPORTANCE Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
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                Author and article information

                Contributors
                Habibollah Azarbakhsh:
                ORCID: https://orcid.org/0000-0002-2772-9876
                Role: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Fatemeh Rezaei: Role: Data curationRole: Writing – original draft
                Jafar Hassanzadeh: Role: Investigation
                Seyed Parsa Dehghani: Role: Resources
                Maryam Janfada: Role: Visualization
                Alireza Mirahmadizadeh:
                ORCID: https://orcid.org/0000-0002-2259-4984
                Role: ConceptualizationRole: Project administrationRole: Validation
                Journal
                Journal ID (nlm-ta): Arch Iran Med
                Journal ID (iso-abbrev): Arch Iran Med
                Journal ID (publisher-id): Arch Iran Med
                Journal ID (publisher-id): AIM
                Title: Archives of Iranian Medicine
                Publisher: Academy of Medical Sciences of I.R. Iran
                ISSN (Print): 1029-2977
                ISSN (Electronic): 1735-3947
                Publication date (Print): October 2023
                Publication date (Electronic): 01 October 2023
                Volume: 26
                Issue: 10
                Pages: 547-553
                Affiliations
                1Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                2Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
                3Research Center for Health Sciences, Institute of Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
                4School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
                5Medical Records, Health Vice-chancellor, Shiraz University of Medical Sciences, Shiraz, Iran
                6Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                [* ] Corresponding Author: Alireza Mirahmadizadeh, Email: mirahmadia@ 123456sums.ac.ir
                Author information
                https://orcid.org/0000-0002-2772-9876
                https://orcid.org/0000-0002-2259-4984
                Article
                DOI: 10.34172/aim.2023.80
                PMC ID: 10862090
                PubMed ID: 38310410
                SO-VID: 0ec8f61c-5b25-413f-a10b-b0c13ef1a371
                Copyright © © 2023 The Author(s).
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 01 December 2022
                Date accepted : 22 July 2023
                Categories
                Subject: Original Article

                Keywords: iran,joinpoint regression,leukemia,mortality rate,years of life lost
                Data availability:
                Keywords: iran, joinpoint regression, leukemia, mortality rate, years of life lost

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