The Incidence and Survival of AcuteDe NovoLeukaemias in Estonia and in a Well Defined Region of Western Sweden During 1982 – 1996: A Survey of Patients Aged 16 – 64 Years

Abstract

In the present work the incidence and survival of acute de novo leukaemias in two neighbouring countries, were studied retrospectively over three 5-year periods, 1982-1996. The aim was to compare the above variables, particularly with respect to political/socio-economic and environmental factors, in a well defined area of Sweden, the so-called Western Swedish Health Care Region, with Estonia. Population-wise the Western Swedish Region and Estonia are very similar; area-wise they are also well comparable. The present report covers only patients diagnosed between the ages of 16-64 years. The number of acute de novo leukaemias in the two regions was quite similar (Western Sweden n = 282 and Estonia n = 237). The age standardized incidence rate regarding total acute de novo leukaemias was slightly lower in Estonia than in Western Sweden (1.49/100,000 inhabitants/year for Estonia and 1.76 for Sweden, respectively), the difference being not statistically significant. However, the survival data for the two countries were highly different (P < 0.001). Thus, the relative survival for the total group of patients aged 16-64 years in Estonia at 1 year was 20.7% and at 5 years 3.6%, respectively. The corresponding figures for the Swedish patients were considerably higher, 65.2 and 29.4%, respectively. Further, the 5 year survival significantly (P < 0.05) increased for the Swedish patients over the 3 consecutive 5-year periods. No such improvement was recorded for the Estonian patients.

Association of Human Development Index with rates and outcomes of hematopoietic stem cell transplantation for patients with acute leukemia

“…[20][21][22][23][24][25][26][27] With regard to adults with acute leukemia, the impact of the SES on survival was indirectly demonstrated by studies comparing patients treated between 1982 and 1996 in Estonia and Western Sweden, the 2 regions characterized by different political and economic systems, with similar ethnic and geographic background. 28,29 Swedish patients had a significantly higher chance of cure compared with their Estonian counterparts. 28,29 Fagundes et al, using the HDI to evaluate the SES of adults with AML in Brazil, showed the differences of outcome, which were in major part dependent on the compliance to chemotherapy protocol.…”

“…28,29 Swedish patients had a significantly higher chance of cure compared with their Estonian counterparts. 28,29 Fagundes et al, using the HDI to evaluate the SES of adults with AML in Brazil, showed the differences of outcome, which were in major part dependent on the compliance to chemotherapy protocol. 30 Until now, few studies focused on the association of socioeconomic factors with HSCT.…”

The Incidence and Survival of Acute de novo Leukemias in Estonia and in a Well-Defined Region of Western Sweden during 1997–2001: A Survey of Patients Aged 16–64 Years

“…In Estonia, the annual age-standardized incidence per 100,000 inhabitants for de novo AL was 1.77 (1.38–2.16); for western Sweden, the corresponding figure was 2.17 (1.78–2.57). For comparison, table 4 shows joint information as regards age-standardized incidence rates of de novo AL, AML and ALL in the population aged 16–64 years over four consecutive 5-year periods between 1982 and 2001 in western Sweden and Estonia; information for the period 1982–1996 was gathered from our recent publication [1]. …”

“…The relative survival for ALL at 5 years was quite similar for Swedish and Estonian patients (29.1 and 23.3%, respectively). Figures 2 and 3 show relative survival for de novo AML for the population aged 16–64 years over four consecutive 5-year periods between 1982 and 2001 in western Sweden and Estonia, respectively; information for the period 1982–1996 was gathered from our recent publication [1]. …”

“…In view of the political and socioeconomic differences between Estonia and its neighbor Sweden, in a recent population-based survey we retrospectively compared the incidence and survival of de novo acute leukemia (AL) patients aged 16–64 years over three 5-year periods (1982–1996) in these two countries (the whole of Estonia and a well-defined region of western Sweden) [1]. …”