Adult leukemia in Florida 2010-2019: diverse, aging population as an indicator for the United States

Ming S. Lee ∗ , Rebecca E. Kaiser ∗ , Christopher D. Armstrong , David B. Dukenik , Nancy S. Elliott , Raymond R. Balise , Justin M. Watts , Mikkael A. Sekeres , Erin N. Kobetz , Justin Taylor
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Abstract

According to recent data released by the National Cancer Institute, Florida has the highest incidence of adult leukemia in the United States. There is limited population-based research on aging and sociodemographic disparities associated with leukemia in Florida, which can have a national impact on the assessment of leukemia burden. Using geocoded cancer data from the Florida Cancer Data System and population data from the US Census, this study evaluated socioeconomic and regional disparities associated with leukemia and found that leukemia disparities by race/ethnicity and rurality exist in Florida. The non-Hispanic White population had the highest incidence rates for most subtypes of leukemia, whereas the non-Hispanic Black population had the highest odds of dying from leukemia. Rural counties and urban neighborhoods with lower socioeconomic status were associated with higher mortality odds for leukemia. Leukemia-treating physician numbers were mismatched in regions in which patients with leukemia exhibit higher incidence and mortality odds. These results suggest that leukemia incidence rate in Florida is likely to remain among the highest in the United States due to population aging; however, physician shortages may exacerbate disparities and limit care in rural areas. Florida demographically looks like what the entire US population may be in the future and is therefore an indicator of the coming needs in the United States for increased leukemia diagnosis, treatment, and survivorship care. Larger national and international studies can build on this study by applying our methodology on a larger scale and can also be applied to other hematologic malignancies and other cancer types.
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