| Objective To analyze trends in the disease burden of leukemia and its subtypes in China from 1990 to 2023, and to provide scientific evidence for optimizing prevention and treatment strategies and reducing the disease burden. Methods Based on the Global Burden of Disease Study 2023 database, we extracted all-age and age-standardized data on prevalence, mortality, and disability-adjusted life-years (DALYs) for leukemia subtypes in China from 1990 to 2023. Trends in disease burden were analyzed using Joinpoint regression, an age-period-cohort model was constructed, and decomposition analysis was performed to explore the contributing factors to changes in the disease burden of leukemia and its subtypes. All analyses were conducted using R version 4.5.1. Results In 2023, age-standardized prevalence rates for leukemia, acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML) in China were 43.94, 20.16, 13.76, 3.29, and 0.93 per 100 000 population. The age-standardized estimated average annual percentage change (EAPC) values were 1.18%, 1.11% , 3.01%, 1.00%, and 0.79%, all indicating upward trends. Males exhibited higher prevalence, mortality, and DALYs rates than females. Joinpoint regression analysis revealed that the age-standardized mortality rates (ASMR) for leukemia, ALL, AML, CML, and other leukemia all showed decreasing trends from 1990 to 2023, with average annual percent changes (AAPC) of ?1.47%, ?2.63%, ?1.01%, ?4.42%, and ?0.42%, respectively, whereas CLL demonstrated a slow upward trend. The age–period–cohort model showed that among individuals aged 0~29 years, mortality rates for all subtypes declined with age, and the decline was greater in females than in males; except for ALL, the mortality risk of all other subtypes decreased across successive birth cohorts; the mortality risk of each subtype continued to decrease over calendar time, reaching its lowest in 2019–2023, and after 2004–2008, the mortality risk in males exceeded that in females. Analyses of local drift and net drift demonstrated that mortality rates for leukemia and its subtypes have shown a significant downward trend, with the decline being greater among women than among men. CML has shown the fastest decline; mortality rates for all subtypes have trended downward among females, while among males, there are signs of rising mortality rates in a specific age group for CLL (after age 85). Decomposition analysis indicated that the increase in the number of prevalent cases was primarily driven by epidemiological changes (65.04%) and population (31.64%). The declines in the number of deaths and DALYs were mainly attributable to epidemiological changes, which accounted for 233.67% and 116.47% of the reductions, respectively. Conclusion From 1990 to 2023, the prevalence of leukemia and its major subtypes in China showed an upward trend; however, ASMR and ASDR continued to decline, leading to an overall reduction in disease burden. Epidemiological changes and population were the core drivers of the increase in prevalent cases, while the decreases in the number of deaths and DALYs were primarily attributable to epidemiological changes. |
