Abstract
BACKGROUND: In China, leukemia remains one of the top ten causes of death, and understanding its mortality trends is crucial for public health planning. This study analyzed the mortality trends of leukemia in China from 2004 to 2021, exploring differences by gender, age, and urban versus rural regions. METHODS: Mortality data from the "Chinese Death Cause Monitoring Results Datasets" (2004-2021) were analyzed using Joinpoint regression analysis, which identifies changes in trend slopes and provides insight into significant shifts in mortality rates. The study calculated the annual percent change (APC) and average annual percent change (AAPC) for the overall and subgroup mortality rates. RESULTS: The analysis revealed a general decline in leukemia mortality over the 18-year study period. The age-standardized mortality rate (ASMR) for leukemia in China has decreased significantly from 4.492/10(5) in 2004 to 3.517/10(5) in 2021, representing a reduction of 21.71%. Gender-specific trends showed that while the APC for males was - 1.23% (95%CI: -1.55% to -0.97%, P < 0.001), female APC experienced a more pronounced decline of -1.33% (95% CI: -1.68% to -0.97%, P < 0.001). Regional differences were also evident: urban areas saw a sharper decline in ASMR, from 4.424/10(5) in 2004 to 2.915/10(5) in 2021, reflecting a 34.11% reduction, with an APC of -2.26% (95% CI: -2.87% to -1.63%, P < 0.001). By contrast, rural areas showed a slower reduction, with an APC of -0.61% (95% CI: -0.86% to -0.34%, P < 0.001), resulting in a decrease of 13.29% from 2004 to 2021. Because crude mortality rates (CMR) are influenced by changes in population age structure, the ASMR is used as the primary indicator for interpreting long-term trends in leukemia mortality. These findings highlight significant disparities in the rate of decline between urban and rural regions, as well as between genders. The overall AAPC for ASMR was - 1.26% (95% CI: -1.55% to -0.97%, P < 0.001), indicating a consistent downward trend in leukemia-related mortality. CONCLUSION: Between 2004 and 2021, the overall leukemia mortality rate in China showed a declining trend. However, significant disparities were observed between the genders and regions. Our findings suggest that future prevention and treatment efforts may need to pay increased attention to high-risk populations, such as those in rural areas and male individuals, to further reduce leukemia mortality rates.