Regional and national burden of leukemia and its attributable burden to risk factors in 21 countries and territories of North Africa and Middle East, 1990-2019: results from the GBD study 2019

Mahsa Heidari-Foroozan; Sahar Saeedi Moghaddam; Mohammad Keykhaei; Parnian Shobeiri; Sina Azadnajafabad; Zahra Esfahani; Negar Rezaei; Maryam Nasserinejad; Nazila Rezaei; Elham Rayzan; Zahra Shokri Varniab; Ali Golestani; Rosa Haghshenas; Farzad Kompani; Bagher Larijani; Farshad Farzadfar

doi:10.1007/s00432-022-04293-7

Regional and national burden of leukemia and its attributable burden to risk factors in 21 countries and territories of North Africa and Middle East, 1990-2019: results from the GBD study 2019

J Cancer Res Clin Oncol. 2023 Jul;149(8):4149-4161. doi: 10.1007/s00432-022-04293-7. Epub 2022 Sep 1.

Authors

Mahsa Heidari-Foroozan^#^{1

2}, Sahar Saeedi Moghaddam^#¹, Mohammad Keykhaei³, Parnian Shobeiri¹, Sina Azadnajafabad¹, Zahra Esfahani^{1

4}, Negar Rezaei¹, Maryam Nasserinejad^{1

5}, Nazila Rezaei¹, Elham Rayzan^{1

6}, Zahra Shokri Varniab¹, Ali Golestani¹, Rosa Haghshenas¹, Farzad Kompani⁷, Bagher Larijani⁸, Farshad Farzadfar^{9

10}

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No. 10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran.
² Student Research Center Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Feinberg Cardiovascular and Renal Research Institute, Northwestern University School of Medicine, IL, 60611, Chicago, USA.
⁴ Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
⁵ Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
⁶ Department of Pediatric Hematology and Oncology, Boston Children's Hospital, Harvard Medical School, MA, Boston, USA.
⁷ Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No. 10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran. f-farzadfar@tums.ac.ir.
¹⁰ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. f-farzadfar@tums.ac.ir.

^# Contributed equally.

PMID: 36048271
DOI: 10.1007/s00432-022-04293-7

Abstract

Purpose: Regional and national data on leukemia's burden provide a better comprehension of leukemia's trends and are vital for policy-makers for better allocation of the resources. This study reports the burden of leukemia, and the attributed burden to its risk factors in 21 countries and territories of the North Africa and Middle East.

Methods: Data from cancer registration, scientific literature, survey, and reports were the input to estimate the burden of leukemia. In addition, the burden of attributable risk factors with evidence of causation with leukemia was calculated using the comparative risk assessment framework. All measures are reported as counts and rates divided by sex and specific age groups.

Results: In 2019, there were 39,297 (95% uncertainty interval: 32,617-45,056) incident cases of leukemia with an age-standardized rate (ASR) of 7.8 (6.5-8.8) per 100,000 in the region. There were also 25,143 (21,109-28,826) deaths and 1,011,555 (822,537-1,173,621) DALYs attributed to Leukemia with an ASR of 5.4 (4.6-6.1) per 100,000 and 183.4 (150.7-211.2) per 100,000, respectively. Years of life lost (YLLs) (179.4 [147.2-206.7]) were accountable for the major part of DALYs. All count measures increased, while all the ASRs decreased during 1990-2019. The Syrian Arab Republic, Qatar, and Afghanistan had the highest ASR incidence, mortality, and DALYs rate in 2019. Incidence, DALYs, and prevalence rates were higher in males of all age groups except under five, and the highest rates were observed in +75 age group. Four major risk factors for leukemia were smoking, high body mass index, occupational exposure to benzene, and formaldehyde.

Conclusion: Despite the reduction in age-standardized rates of incidence and mortality, the burden of leukemia has increased steadily, due to population growth and aging. Notable variations exist between age-standardized rates in region's countries.

Keywords: Attributable risk factor; Cancer; Global burden of disease; Leukemia; North Africa and Middle East.

MeSH terms

Africa, Northern / epidemiology
Global Burden of Disease*
Humans
Leukemia* / epidemiology
Male
Middle East / epidemiology
Risk Factors