hrs4r
 I want to donate

Incidence of myeloid neoplasms analyzed for the first time in Spain

15 February 2022
  • By 2021, almost 8,500 cases of these hematological cancers could have been diagnosed in Spain, according to a study by the Spanish Network of Cancer Registries (REDECAN) and CIBERESP.
  • The incidence rates in the major subgroups were 5.14 cases per 100,000 population for myeloproliferative neoplasms, 4.71 for myelodysplastic syndromes and 3.91 for acute myeloid leukemia.
  • Myeloid neoplasms are diagnosed more in males and the average age for diagnosis is 73 years.

A total of 8,446 cases of myeloid neoplasms could have been diagnosed in Spain by 2021. These estimates are contained in a study by the Spanish Network of Cancer Registries (REDECAN) and the CIBER of Epidemiology and Public Health (CIBERESP), which has been published in the journal Scientific Reports and presents the first exhaustive population-based analysis of the incidence of these type of cancer in Spain. The Research Group on Statistics, Econometrics and Health (GRECS) of the University of Girona, the Epidemiology and Cancer Registry Unit of Girona (ICO-IDIBGI) and the Josep Carreras Leukemia Research Institute have also participated in the study.

Myeloid neoplasms are a group of hematologic cancers characterized by excessive proliferation, self-renewal or altered differentiation in hematopoietic stem cells (whose stem cells derive the different types of blood cells) or myeloid progenitors (precursors of erythrocytes, granulocytes, monocytes and platelets). Broadly speaking, these cancers fall into four major categories: myeloproliferative neoplasms (MPN), myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), and MDS/MPN overlap syndromes.

By 2021, almost 8,500 cases of these hematologic cancers could have been diagnosed in Spain, according to a study by the Spanish Network of Cancer Registries (REDECAN) and CIBERESP.
The incidence rates in the large subgroups were 5.14 cases per 100,000 population for myeloproliferative neoplasms, 4.71 for myelodysplastic syndromes and 3.91 for acute myeloid leukemia.
Myeloid neoplasms are diagnosed more in males and the average age at diagnosis is 73 years.
By 2021 a total of 8,446 cases of myeloid neoplasms could have been diagnosed in Spain. These estimates are contained in a study by the Spanish Network of Cancer Registries (REDECAN) and the CIBER of Epidemiology and Public Health (CIBERESP), which has been published in the journal Scientific Reports and presents the first exhaustive population-based analysis of the incidence of cancer in Spain. The Research Group on Statistics, Econometrics and Health (GRECS) of the University of Girona, the Epidemiology and Cancer Registry Unit of Girona (ICO-IDIBGI) and the Josep Carreras Leukemia Research Institute have also participated in the study.

Myeloid neoplasms are a group of hematological cancers characterized by excessive proliferation, self-renewal or altered differentiation in hematopoietic stem cells (whose stem cells derive the different types of blood cells) or myeloid progenitors (precursors of erythrocytes, granulocytes, monocytes and platelets). Broadly speaking, these types of cancers fall into four broad categories: myeloproliferative neoplasms (MPNs), myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), and MDS/MPN overlap syndromes.

"This is a group of diseases with very heterogeneous etiology, clinical presentation and prognosis, making it essential to provide detailed epidemiological data by histological subtype. However, this is not always feasible in regional studies, since several subtypes are very low incident. Therefore, large-scale collaborative cancer registry projects provide the opportunity to carry out this type of analysis," explain Dr. Marta Solans and Dr. Rafael Marcos-Gragera, researchers from the Descriptive epidemiology, genetics and cancer prevention of ICO Girona and Girona Biomedical Research Institute (IDIBGI), from the Research Group on Statistics, Econometrics and Health (GRECS) of the University of Girona and CIBERESP, and two of the coordinators of this work.

In this study, the incidence of myeloid neoplasms during 2002-2013 was analyzed based on data from 13 Spanish cancer registries -five coordinated by CIBERESP researchers-, including a total of 17,522 cases of this type of neoplasm. The registries analyzed, integrated in REDECAN, would cover approximately 26% of the Spanish population.

30% of hematologic cancers, which affect more men

The results confirmed that myeloid neoplasms accounted for 30.81% of all cases of hematological cancers diagnosed in Spain. Of these, 33.5% corresponded to MPN; 29.8% to MDS; 25.7% to AML; 5.2% to MDS/MPN; 2.3% to acute leukemia of ambiguous lineage; and the remaining 3.6% corresponded to nonspecific cases.

Specifically, in the large subgroups, the age-adjusted incidence rates (expressed per 100,000 population) were 5.14 for myeloproliferative neoplasms (MPN), 4.71 for myelodysplastic syndromes (MDS), 3, 91 for acute myeloid leukemia (AML), 0.83 for MDS/MPN, 0.35 for cases of acute leukemia of ambiguous lineage, and 0.58 for nonspecific cases.

The study also confirms the higher prevalence of myeloid neoplasms in men (55.1% of diagnoses) and the increase in incidence due to age, with the average age of diagnosis of this type of cancer being 73 years.

Importance of monitoring these neoplasms

Over the last few decades there have been major advances in the field of hematoncology, which have resulted in constant changes in the definition, classification, diagnosis and management of these neoplasms. Large-scale studies with clinically relevant subtype data contribute to monitoring these diseases.

This work is based on the World Health Organization (WHO) classification of hematological malignancies, first published in 2001 and subsequently updated in 2008 and 2016. Refinements in its definitions complicate in the registration of these diseases and lead to problems when comparing data with previous studies or other European projects.

Thus, differences between provinces were particularly notable for MPNs, MDS and MDS/MPN. These three entities began to be systematically registered from 2000 onwards (previously they were not considered malignant) and several are followed on an outpatient basis, so that they can escape the routine information flows of cancer registries. Thus, much of these differences are probably attributable to aspects of registry completeness rather than risk factors.

The study also found that nonspecific cases are mostly focused on elderly patients (>70 years), suggesting that this group of patients may be suboptimally diagnosed and therefore treated, given the greater difficulty in performing more aggressive tests or treatments in the elderly.

On the other hand, the incidence remained stable for AML throughout the period, decreased markedly for nonspecific cases and increased sharply for PMN, MDS and MDS/MPN. This increase can largely be attributed to improvements in the diagnosis and registration of these diseases.

Projections to 2021 will help measure the impact of the pandemic

The study also provides incidence projections for 2021. A total of 8,446 new cases were estimated in the year just ended, although these data should be interpreted with caution given methodological limitations (some subtypes are very rare), classification changes that occurred in 2016, and the current pandemic context.

In this regard, the researchers point out that "although the full extent of the impact of the health situation generated by Covid-19 is unknown, it is expected that delays in cancer diagnosis will lead to a short-term decrease in cases, followed by an increase in the incidence of advanced stage diagnoses".

However, "the results obtained are of great interest to public health specialists, in order to evaluate the cost, management and new treatments for these pathologies, and to account for the gap between expected cases and those observed after the pandemic," they conclude.

Reference article:

Solans, M., Sanvisens, A., Ameijide, A. et al. Incidence of myeloid neoplasms in Spain (2002–2013): a population-based study of the Spanish network of cancer registries. Sci Rep 12, 323 (2022). https://doi.org/10.1038/s41598-021-03734-6

Historical

Back to blog

About IDIBGI!

menu