The incidence and survival of acute de novo leukaemias in Estonia and in a well‐defined region of western Sweden during 1982–1996: a survey of patients aged ≥65 years

• Published in: Journal of internal medicine Vol. 256; no. 1; pp. 79 - 85
• Main Authors: Luik, E., Palk, K., Everaus, H., Varik, M., Aareleid, T., Wennström, L., Juntikka, E.‐L., Safai‐Kutti, S., Stockelberg, D., Holmberg, E., Kutti, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.07.2004; Blackwell Science; Blackwell Publishing Ltd
• Subjects: acute de novo leukaemia; Aged; Biological and medical sciences; Delivery of Health Care; Environment; Estonia; Estonia - epidemiology; Female; General aspects; Hematologic and hematopoietic diseases; Humans; Incidence; Leukemia - epidemiology; Leukemia - mortality; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Risk Factors; Socioeconomic Factors; survival; Survival Rate; Sweden; Sweden - epidemiology; Sweden; Eastern Europe; Europe; Estonia; Human; acute de novo leukaemia; Acute; Leukemia; Malignant hemopathy; Epidemiology; Survival; De novo; Incidence; Medicine; 1996; Survey; Sweden; Surveillance; Estonia
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/j.1365-2796.2004.01335.x

. Objectives.  To compare the incidence and survival of acute de novo leukaemias with particular reference to political/socio‐economic and environmental factors in two neighbouring countries over the three 5‐year periods (1982–1996). Patients.  The present report covers only patients diagnosed when aged ≥65 years. Setting.  A well‐defined area of Sweden, the so‐called Western Swedish Health Care Region and Estonia. Population‐wise, the western Swedish Region and Estonia are very similar; area‐wise they are also well comparable. Results.  The number of acute de novo leukaemias was quite dissimilar in the two countries (Estonia, n = 137, Sweden, n = 354). The age standardized incidence rates regarding the total number of acute de novo leukaemias was 5.31 per 100 000 inhabitants/year for Estonia and 7.99 for Sweden, this difference being statistically significant. However, the difference was merely attributable to incidence rates as regards acute myeloblastic leukaemias (AML); on the contrary, differences as regards acute lymphoblastic leukaemias (ALL) and non‐classifiable, undifferentiated or biphenotypic acute leukaemias (uAL) were negligible. The relative survival for the total material of patients was significantly higher for Swedish when compared with Estonian patients (P < 0.001). Thus, the relative survival for the total material of patients aged ≥65 years in Estonia at 1 year was 8.5% and at 3 years 3.5% respectively. The corresponding figures for the Swedish patients were considerably higher, 22.7 and 7.7% respectively. This difference, however, applied only for patients with AML (P < 0.001), whereas the results for patients with ALL and uAL were equally dismal. Conclusion.  The results clearly reflect how political and socio‐economic factors may influence the survival of acute leukemia patients in two neighbouring countries.