National cancer system metrics and leukemia outcomes: an analysis of global data for pediatric and adult patients

Abstract

Globally, nearly 500,000 individuals were diagnosed with leukemia in 2022 alone [1]. In 2022, leukemia was among the top ten causes of cancer death in 71 countries in adults and the leading cause of cancer death in 96 countries in children [1, 2]. However, significant global heterogeneity exists in the incidence of various leukemias and their associated mortality [1, 3]. Less-resourced countries have been shown to have higher leukemia mortality-to-incidence ratios (MIR), highlighting health system inequities across countries [1]. For example, from 2010–2014, for pediatric acute lymphoblastic leukemia, the 5-year survival was 65.9% in Thailand versus 95.2% in Finland [3]. Survival disparities are mirrored among adults. From 2010–2014, for adult myeloid malignancies, the 5-year survival was 16.5% in Chile versus 57.5% in France [3].

While global disparities in both pediatric and adult leukemia have been documented [1, 3], further work is needed to elucidate how to translate these findings into cancer health system strengthening measures at the national and global levels. A detailed understanding of the levers that drive these cancer-specific infrastructures may inform health system planning specific to leukemia. Therefore, we used global health system data from the World Health Organization, the World Bank, the DIrectory of RAdiotherapy Centers, the United Nations Development Program, and the International Agency for Research on Cancer (IARC) to evaluate predictors of improved pediatric and adult leukemia outcomes globally.