Incidence,mortality and risk factors of hematologic malignancies in China from 1990 to 2021: A systematic analysis for the GBD 2021

Abstract

Objective:

This study aimed to systematically analyze the incidence, mortality, and risk factors of hematologic malignancies and their subtypes in China from 1990-2021.

Methods:

The study utilized data from the Global Burden of Disease 2021 database. Trends in incidence and mortality rates of hematologic malignancies from 1990-2021 were measured using estimated annual percentage change (EAPC) with 95% confidence intervals. Future burden in China up to 2035 was projected using Bayesian age-period-cohort modeling.

Results:

Between 1990 and 2021, China saw rising age-standardized incidence rates for multiple myeloma, non-Hodgkin lymphoma, and leukemia, but a decline for Hodgkin lymphoma. Mortality decreased for leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma, while increasing for multiple myeloma. Among leukemia subtypes, incidence fell for acute myeloid, chronic myeloid, and other leukemias but rose for acute and chronic lymphoid leukemias. Mortality declined across all five subtypes. Males had higher incidence and mortality than females for all hematologic malignancies. The 65–69 age group had the highest number of cases and deaths. Children under 5 years of age were most affected by leukemia, mainly acute lymphoid leukemia. High BMI was a significant risk factor. Projections to 2035 suggest continued increases in incidence and mortality for multiple myeloma, but declining leukemia mortality. Incidence of acute lymphoblastic and other leukemias is expected to fall, with mortality improving for all leukemia subtypes.

Conclusions:

China’s hematologic malignancy burden remained high in 2021 and is projected to persist through 2035. BMI is a key driver, highlighting the need for targeted control measures to reduce this burden.