Hematologic malignancies are among the most common cancers, and understanding their incidence and death is crucial for targeting prevention, clinical practice improvement, and research resources appropriately. Here, we investigated detailed information on hematological malignancies for the period 1990–2019 from the Global Burden of Disease study. The age-standardized incidence rate (ASIR), the age-standardized death rate (ASDR), and the corresponding estimated annual percentage changes (EAPC) were calculated to assess temporal trends in 204 countries and territories over the past 30 years. Globally, incident cases of hematologic malignancies have been increasing since 1990, reaching 1343.85 thousand in 2019, but the ASDR for all types of hematologic malignancies has been declining. The ASDR for leukemia, multiple myeloma, non-Hodgkin lymphoma, and Hodgkin lymphoma were 4.26, 1.42, 3.19, and 0.34 per 100,000 population in 2019, respectively, with Hodgkin lymphoma showing the most significant decline. However, the trend varies by gender, age, region, and the country’s economic situation. The burden of hematologic malignancies is generally higher in men, and this gender gap decreases after peaking at a given age. The regions with the largest increasing trend in the ASIR of leukemia, multiple myeloma, non-Hodgkin lymphoma, and Hodgkin lymphoma were Central Europe, Eastern Europe, East Asia, and Caribbean, respectively. In addition, the proportion of deaths attributed to high body-mass index continued to rise across regions, especially in regions with high socio-demographic indices (SDI). Meanwhile, the burden of leukemia from occupational exposure to benzene and formaldehyde was more widespread in areas with low SDI. Thus, hematologic malignancies remain the leading cause of the global tumor burden, with growing absolute numbers but sharp among several age-standardized measures over the past three decades. The results of the study will inform analysis of trends in the global burden of disease for specific hematologic malignancies and develop appropriate policies for these modifiable risks.
血液系统恶性肿瘤是最常见的癌症之一，了解其发病率和死亡率对于精准实施预防措施、改进临床实践以及合理配置研究资源至关重要。本研究基于全球疾病负担研究，系统分析了1990年至2019年间血液系统恶性肿瘤的详细数据。通过计算年龄标准化发病率（ASIR）、年龄标准化死亡率（ASDR）及相应的估计年度百分比变化（EAPC），评估了过去30年间204个国家和地区的趋势变化。全球范围内，血液系统恶性肿瘤的新发病例自1990年以来持续上升，至2019年已达134.385万例，但所有类型的年龄标准化死亡率均呈下降趋势。2019年白血病、多发性骨髓瘤、非霍奇金淋巴瘤和霍奇金淋巴瘤的年龄标准化死亡率分别为每10万人4.26例、1.42例、3.19例和0.34例，其中霍奇金淋巴瘤的降幅最为显著。然而，这一趋势因性别、年龄、地区和国家经济状况而异。男性血液系统恶性肿瘤负担普遍更高，且性别差异在特定年龄达到峰值后逐渐缩小。白血病、多发性骨髓瘤、非霍奇金淋巴瘤和霍奇金淋巴瘤年龄标准化发病率增长最快的地区分别为中欧、东欧、东亚和加勒比地区。此外，高体重指数导致的死亡比例在各地区持续上升，尤其在社经人口指数（SDI）较高区域更为明显。同时，职业接触苯和甲醛所致的白血病负担在低SDI地区更为普遍。综上，血液系统恶性肿瘤仍是全球肿瘤负担的主要原因，过去三十年间其绝对病例数持续增长，但多项年龄标准化指标呈现显著下降趋势。本研究结果将为分析特定血液系统恶性肿瘤的全球疾病负担趋势、制定针对可调控风险因素的政策提供依据。
Global burden of hematologic malignancies and evolution patterns over the past 30 years
肿瘤(癌症)患者之家