Trends of chronic lymphocytic leukemia incidence and mortality in the United States: a population-based study over the last four decades

ABSTRACT

Background

Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults, and its incidence is higher in elderly individuals. This study aims to examine the burden of CLL in the United States (US) by exploring the incidence-based rates (IBR) and incidence-based mortality (IBMR) across four decades.

Research design and methods

CLL incidence data were obtained from the SEER-8 registry, covering 8.3% of the US population. Cases were identified using specific diagnostic codes and excluded if diagnosed on autopsy or death certificate. Age-standardized IBR and IBMR were calculated based on age, sex, and ethnicity/race. Joinpoint Regression Program was used to analyze changing trends in incidence and mortality.

Results

Since 2011, males’ and females’ IBRs declined by −1.72%/year (p = 0.028) and −1.07%/year (p = 0.222), respectively. IBR of patients > 75 years increased by 4.01%/year (p < 0.001) form 1998–2010, then declined by 2.02%/year (p = 0.011). IBR of Blacks increased by 0.96%/year (p < 0.001) throughout the study period. CLL IBMR stabilized at −0.38%/year (p = 0.457) since 2012. Whites’ IBMR plateaued at a rate of −0.10%/year (p = 0.857) form 2012–2019, while blacks’ IBMR increased by 1.40%/year (p = 0.056) between 2000–2019.

Conclusions

The analysis revealed a decline in CLL incidence since 2013, with stable mortality rates since 2012, indicating advancements in CLL management.

KEYWORDS:

• CLL
• SEER
• epidemiology
• incidence
• incidence-based mortality

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Y Alabrach contributed to the conception and design of the study, data acquisition and curation, data analysis and interpretation, and writing and critically revising the manuscript. A Mahmoud contributed to the conception and design of the study, writing the manuscript and critically revised the manuscript and provided valuable feedback. A Abdelhay contributed to the conception and design of the study, and critically revised the manuscript and provided valuable feedback. M Mansour contributed to the conception and design of the study, writing the manuscript and critically revised the manuscript and provided valuable feedback. S Adra contributed to the conception and design of the study, data acquisition and curation, data interpretation, and writing and critically revising the manuscript.

Acknowledgments

We would like to acknowledge that the data presented in this article has been previously shared as an abstract at the American Society of Hematology (ASH) Annual Meeting (doi: 10.1182/blood-2022-169374).

Ethics approval and consent to participate

The study utilized de-identified public data from the SEER database, complied with the principles outlined in the World Medical Association’s Declaration of Helsinki for Ethical Human Research, and did not involve interaction with human subjects or the use of personal identifying information. The study did not require informed consent from the SEER registered cases and the authors obtained limited-use data agreements from SEER. No trial registration was necessary.

Availability of data and materials

The data used in this study is available free of charge at www.seer.cancer.gov upon request. All data generated or analyzed during this study are included in this published article.

Additional information

Funding

This paper was not funded.