Abstract：
BACKGROUND: Childhood leukemia (CL) is the most prevalent form of pediatric cancer on a global scale. However, there is a limited understanding of the dynamics of CL incidence in South America, with a specific knowledge gap in Colombia. This study aimed to identify trends in CL incidence and to analyze the effects of age, period, and birth cohort on the risk of leukemia incidence in this population.
METHODS: Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population-based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-period-cohort models addressing the identifiability issue through the application of double differences.
RESULTS: A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person-years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities.
CONCLUSIONS: This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.
METHODS: Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population-based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-period-cohort models addressing the identifiability issue through the application of double differences.
RESULTS: A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person-years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities.
CONCLUSIONS: This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.
摘要：
背景：儿童白血病（CL）是全球范围内最普遍的儿科癌症。然而,对南美CL发病率的动态了解有限，在哥伦比亚有一个特定的知识差距。这项研究旨在确定CL发病率的趋势，并分析年龄的影响，period,和出生队列研究该人群白血病发病率的风险。
方法：关于0-18岁居民中所有新诊断的白血病病例（一般和亚型）的信息，居住在卡利（2008-2017）的人口癌症登记处的服务地区，Bucaramanga（2000-2017），马尼萨莱斯（2003-2017），和Pasto（1998-2018）。使用连接点回归模型计算了发病率随时间的估计年度百分比变化（EAPC）以及这些EAPC斜率的潜在变化。年龄的影响，period,和队列的CL发病率趋势使用年龄-时间段-队列模型进行评估,通过应用双重差异解决可识别性问题.
结果：共发现966例儿童白血病病例。计算并表达了每100,000人年白血病的平均标准化发病率（ASIR）-观察到卡利的ASIR为4.46，7.27在布卡拉曼加，马尼萨莱斯3.89和帕斯托4.06。关于CL趋势，EAPC在不同时期没有统计学上的显著变化，然而,当按白血病亚型分析时，在ALL和AML的EAPC中观察到统计学上显著的变化.对年龄周期队列模型的分析显示，年龄相关因素显着支撑了这四个哥伦比亚城市儿童白血病的发病率趋势。
结论：这项研究为哥伦比亚四个主要城市儿童白血病的发病趋势提供了有价值的见解。分析显示，不同时期的整体CL发病率稳定，主要受年龄相关因素和不存在队列和时期效应的影响。此信息对于哥伦比亚的CL诊断和治疗的监视和计划目的很有用。
方法：关于0-18岁居民中所有新诊断的白血病病例（一般和亚型）的信息，居住在卡利（2008-2017）的人口癌症登记处的服务地区，Bucaramanga（2000-2017），马尼萨莱斯（2003-2017），和Pasto（1998-2018）。使用连接点回归模型计算了发病率随时间的估计年度百分比变化（EAPC）以及这些EAPC斜率的潜在变化。年龄的影响，period,和队列的CL发病率趋势使用年龄-时间段-队列模型进行评估,通过应用双重差异解决可识别性问题.
结果：共发现966例儿童白血病病例。计算并表达了每100,000人年白血病的平均标准化发病率（ASIR）-观察到卡利的ASIR为4.46，7.27在布卡拉曼加，马尼萨莱斯3.89和帕斯托4.06。关于CL趋势，EAPC在不同时期没有统计学上的显著变化，然而,当按白血病亚型分析时，在ALL和AML的EAPC中观察到统计学上显著的变化.对年龄周期队列模型的分析显示，年龄相关因素显着支撑了这四个哥伦比亚城市儿童白血病的发病率趋势。
结论：这项研究为哥伦比亚四个主要城市儿童白血病的发病趋势提供了有价值的见解。分析显示，不同时期的整体CL发病率稳定，主要受年龄相关因素和不存在队列和时期效应的影响。此信息对于哥伦比亚的CL诊断和治疗的监视和计划目的很有用。
