Incidence and mortality trends of leukemia and lymphoma in Croatia, 1988-2009

Novak, Ina and Jakšić, Ozren and Kuliš, Tomislav and Batinjan, Katarina and Znaor, Ariana (2012) Incidence and mortality trends of leukemia and lymphoma in Croatia, 1988-2009. Croatian Medical Journal, 53 (2). pp. 115-123. ISSN 0353-9504

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Abstract

AIM: To investigate the time trends of leukemia and lymphoma in Croatia from 1988-2009, compare them with trends in other populations, and identify possible changes. ----- METHODS: The data sources were the Croatian National Cancer Registry for incidence data, Croatian Bureau of Statistics for the numbers of deaths, and United Nations population estimates. Joinpoint regression analysis using the age-standardized rates was used to analyze incidence and mortality trends. ----- RESULTS: Acute lymphoblastic leukemia and chronic lymphocytic leukemia incidence did not significantly change. Acute myeloid leukemia incidence significantly increased in women, with estimated annual percentage change (EAPC) of 2.6% during the whole period, and in men since 1998, with EAPC of 3.2%. Chronic myeloid leukemia incidence significantly decreased in women (EAPC -3.7%) and remained stable in men. Mortality rates were stable for both lymphoid and myeloid leukemia in both sexes. Hodgkin lymphoma non-significantly increased in incidence and significantly decreased in mortality (EAPCs of -5.6% in men and -3.7% in women). Non-Hodgkin lymphoma significantly increased in incidence in women (EAPC 3.2%) and non-significantly in men and in mortality in both men (EAPC 1.6%) and women (EAPC 1.8%). ----- CONCLUSION: While Croatia had similar leukemia and lymphoma incidence trends as the other countries, the mortality trends were less favorable than in Western Europe. The lack of declines of leukemia incidence and non-Hodgkin lymphoma mortality could be attributed to late introduction of optimal therapies. As currently the most up-to-date diagnostics and treatments are available and covered by health insurance, we expect more favorable trends in the future.

Abstract in Croatian

Trendovi incidencije i mortaliteta od leukemija i limfoma u Hrvatskoj, 1988.-2009. ----- Cilj Istražiti trendove incidencije i mortaliteta od leukemija i limfoma u Hrvatskoj, 1988.-2009., usporediti ih s trendovima u ostalim populacijama, i identificirati promjene u trendovima. ----- Postupci Podatke o incidenciji prikupili smo iz Hrvatskog registra za rak, podatke o mortalitetu iz Hrvatskog zavoda za statistiku, a koristili smo i populacijske procjene Ujedinjenih naroda. Kako bi analizirali trendove incidencije i mortaliteta proveli smo regresijsku analizu uz pomoć točaka spajanja (engl, joinpoint regression analysis) koristeći stope standardizirane po dobi. ----- Rezultati Incidencija akutne limfatične leukemije i kronične limfocitne leukemije nije se značajno promijenila. Incidencija akutne mijeloidne leukemije značajno je porasla kod žena, s procijenjenim godišnjim postotkom promjene (engl, EAPC) od 2,6% za vrijeme cijelog razdoblja, i kod muškaraca od 1998., s EAPC-om od 3,2%. Incidencija kronične mijeloidne leukemije značajno se smanjila kod žena (EAPC -3,7%) ali je ostala stabilna u muškaraca. Stope mortaliteta ostale su stabilne za limfatičnu i mijeloidnu leukemiju kod oba spola. Hodgkinov limfom imao je porast incidencije koji nije bio značajan, i smanjenje mortaliteta koje je bilo značajno (EAPC od -5,6% kod muškaraca i -3.7% kod žena). Ne-Hodgkinov limfom imao je značajan porast incidencije kod žena (EAPC 3,2%) i ne-značajan kod muškaraca, i porast mortaliteta i kod muškaraca (EAPC 1,6%) i kod žena (EAPC 1,8%). ----- Zaključak Iako je Hrvatska imala slične trendove incidencije leukemija i limfoma kao i ostale europske države, trendovi mortaliteta bili su nepovoljniji nego u zapadno-europskim državama. Izostanak pada mortaliteta od leukemije ne-Hodgkinovog limfoma mogao bi se pripisati kasnom uvođenju najboljih načina liječenja. S obzirom da su trenutno ipak dostupni najnoviji načini dijagnostike i liječenja, u budućnosti očekujemo povoljnije trendove.

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