Global trends in leukemia-related disability-adjusted life years and mortality across socio-demographic index regions, 1980–2023.

Abstract

e18516 Background: Leukemia remains a substantial contributor to global morbidity and mortality, with marked variation in burden across socioeconomic settings. This study aimed to evaluate long-term temporal trends in leukemia-related disability-adjusted life years (DALYs) and age-standardized death rates (ASDR) across countries stratified by Socio-demographic Index (SDI) levels, and to quantify changes over time using annual average percent change (AAPC). Methods: Leukemia burden data were obtained from the Global Burden of Disease (GBD) study, covering the period from 1980 to 2023 for ASDR and from 1990 to 2023 for DALYs. Countries were grouped into low, low-middle, middle, and high-middle SDI categories according to GBD classifications. Age-standardized DALYs and death rates per 100,000 population were analyzed using Joinpoint regression to estimate AAPC with corresponding 95% confidence intervals. Statistical significance was defined as a p value < 0.05. Results: From 1990 to 2023, leukemia-related DALYs demonstrated a consistent downward trend across all SDI categories, with the highest burden persistently observed in high-middle SDI regions. DALYs in this group declined markedly from 297.99 in 1990 to 155.92 in 2023 (AAPC: –1.95; 95% CI: –2.06 to –1.84; p < 0.000001). Middle SDI regions experienced the next highest rates, decreasing from 233.44 to 168.40 over the same period (AAPC: –0.97; 95% CI: –1.12 to –0.82; p < 0.000001). Low-middle SDI countries followed a similar pattern, with DALYs dropping from 162.68 in 1990 to 118.12 in 2023 (AAPC: –0.97; 95% CI: –1.10 to –0.84; p < 0.000001). The lowest DALY levels were observed in low SDI regions, though these still decreased significantly from 189.89 to 144.12 (AAPC: –0.85; 95% CI: –0.94 to –0.75; p < 0.000001). A parallel decline was noted in ASDR trends. From 1980 to 2023, high-middle SDI regions demonstrated the most substantial reduction in leukemia-related ASDR, decreasing from 6.57 to 3.61 (AAPC: –1.39; 95% CI: –1.48 to –1.29; p < 0.000001). Middle SDI regions showed a moderate decrease from 5.13 to 3.88 (AAPC: –0.61; 95% CI: –0.69 to –0.53; p < 0.000001), while low-middle SDI regions showed a comparable reduction from 3.67 to 2.88 (AAPC: –0.54; 95% CI: –0.66 to –0.41; p < 0.000001). Low SDI regions exhibited the smallest but still statistically significant decline, with ASDR decreasing from 4.03 to 3.36 (AAPC: –0.42; 95% CI: –0.50 to –0.34; p < 0.000001). Conclusions: Leukemia related ASDR and DALYs have declined across all SDI categories over the past decades, with the greatest improvements observed in higher-SDI regions. Despite this progress, lower-SDI countries continue to exhibit slower reductions and intermittent periods of increase. These disparities highlight the ongoing need for targeted investments in early diagnosis, treatment access, and health-system strengthening in resource-limited settings.