Mortality and premature life lost from leukemia in China, 2005–2020: A study based on the National Mortality Surveillance System

BACKGROUND: The "Healthy China 2030" initiative, which aims to achieve a 30% reduction in premature mortality by 2030, recognizes leukemia as the primary cause of cancer-related deaths. Given the limited previous research, providing comprehensive national and subnational estimates and temporal trends of the premature leukemia mortality burden from 2005 to 2020 is crucial. METHODS: Using data from various sources acquired through the national surveillance mortality system, estimates were derived and compared across 31 provincial-level administrative regions in the Chinese mainland, revealing the magnitude of mortality rates and years of life lost (YLL) due to leukemia in the Chinese population between 2005 and 2020. RESULTS: In 2020, the estimated number of leukemia-related deaths decreased from 61.93 thousand in 2005 to 54.86 thousand, accompanied by a decline in age-standardized mortality rate (ASMR) from 4.97 per 100,000 population in 2005 to 3.49 per 100,000 population. The burden of premature mortality caused by leukemia exhibited a significant reduction, as indicated by a nationwide decline of -39.37% (from 239.46 to 145.18 per 100,000 population) in the age-standardized YLL rate. Despite a notable decrease (-11.41%) in leukemia mortality, China has the highest burden of leukemia-related deaths due to its large population, primarily driven by population aging (12.76%), which has contributed to an upsurge in leukemia fatalities, followed by population growth (7.67%). Leukemia mortality exhibited distinct variations among different provinces and demonstrated a positive correlation with economic activity, particularly in coastal provinces characterized by higher levels of economic development. Xizang is currently the only province experiencing a significant increase in mortality rate, necessitating urgent government support. CONCLUSIONS: Significant disparities in premature mortality attributed to leukemia were observed across diverse regions of China, underscoring the need for targeted interventions aimed at promoting a health-protective lifestyles and expanding timely access to basic medical insurance for diagnosis and cost-effective therapy, particularly among high-risk populations and regions with limited healthcare resources.