2013年至2019年沈阳市儿童白血病发病及死亡分析

目的:分析沈阳市2013年至2019年儿童白血病发病和死亡变化趋势。方法:从沈阳市肿瘤登记报告系统及居民死因报表中获取0~14岁儿童白血病的发病、死亡数据，计算构成比、发病率、年龄别发病率、死亡率、年龄别死亡率，采用2000年中国标准人口进行标化。应用Joinpoint回归模型进行趋势分析。结果:2013年至2019年沈阳市儿童白血病发病率和标化发病率分别从2013年的0.90/10万、1.34/10万上升至2019年的5.33/10万、5.14/10万，APC分别为19.64%、16.39%。其中，发病率的变化趋势有统计学意义(P＜0.05)。女性发病率年均增长22.77%，变化趋势有统计学意义(P＜0.05)。淋巴样白血病发病率从2013年的0.60/10万上升至2019年的3.77/10万，APC为35.84%，上升趋势有统计学意义（P＜0.05）。2013年沈阳市儿童白血病死亡率和标化死亡率分别为1.50/10万、1.06/10万，2019年儿童白血病死亡率和标化死亡率分别为1.11/10万、1.21/10万，APC分别为-3.80%、-2.53%，趋势变化均无统计学意义（P＞0.05）。男性死亡率年均下降6.25%，女性死亡率年均上升7.07%，但变化趋势均无统计学意义（P＞0.05）。白血病发病和死亡各年龄组均有发生，0~4岁年龄组发病率最高为4.74/10万，10~14岁年龄组死亡率最高为1.93/10万。结论:2013年至2019年沈阳市儿童白血病死亡率相对稳定，发病率呈上升趋势，尤其是女性和淋巴样白血病，应引起高度重视。

Incidence and mortality of childhood leukemia in Shenyang,China from 2013 to 2019

Objective:To analyze the trend of morbidity and mortality of childhood leukemia in Shenyang,China from 2013 to 2019.Methods:The data of incidence and death of childhood leukemia aged 0~14 years old were obtained from Shenyang Cancer Registration and Reporting System and resident cause of death report.The constituent ratio,incidence rate,age-specific incidence rate,mortality rate and age-specific mortality rate were calculated and standardized by Chinese standard population in 2000.Joinpoint regression model was applied for trend analysis.Results:The incidence and standardized incidence of childhood leukemia in Shenyang increased from 0.90/100 000 and 1.34/100 000 in 2013 to 5.33/100 000 and 5.14/100 000 in 2019,respectively,and APC was 19.64% and 16.39%,respectively.Among them,the change trend of incidence rate had statistical significance (P＜0.05).The average annual increase in the incidence of females was 22.77%,and the trend was statistically significant (P＜0.05).The incidence of lymphoid leukemia increased from 0.60/100 000 in 2013 to 3.77/100 000 in 2019,with an APC of 35.84%,and the increasing trend was statistically significant (P＜0.05).In 2013,the mortality rate and standardized mortality rate of childhood leukemia in Shenyang were 1.50/100 000 and 1.06/100 000,respectively,the mortality rate and standardized mortality rate of childhood leukemia in 2019 were 1.11/100 000 and 1.21/100 000,respectively,and the APC were -3.80% and -2.53%,respectively.There were no significant trend changes (P＞0.05).The average annual decrease in mortality was 6.25% in men and the average annual increase in mortality was 7.07% in women,but the trends were not statistically significant (P＞0.05).Leukemia morbidity and mortality occurred in all age groups,with the highest incidence of 4.74/100 000 in the age group of 0~4 years old and the highest mortality of 1.93/100 000 in the age group of 10~14 years old.Conclusion:From 2013 to 2019,the mortality rate of childhood leukemia in Shenyang was relatively stable,and the incidence rate increased,especially in women and lymphoid leukemia,which should be highly concerned.