Long-term trends and future projections of CLL burden in China: a comprehensive analysis from 1990 to 2030 using GBD data

Chronic lymphocytic leukemia (CLL) represents a substantial public health concern in China, marked by a steady rise in incidence over recent years. Examining the long-term patterns and underlying causes is essential for devising effective interventions and shaping relevant policies. This study leveraged data from the Global Burden of Disease (GBD) Study 2021 to assess the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributed to CLL in China from 1990 to 2021. Joinpoint regression analysis pinpointed critical shifts in these trends, while age-period-cohort (APC) analysis and decomposition analysis measured the impact of population aging, epidemiological changes, and population growth on these trends. The findings revealed a notable increase in the incidence and prevalence of CLL in China, especially among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were significantly higher for males compared to females. Decomposition analysis showed that population growth was the main factor driving the increase in incidence, while aging was the primary contributor to rising mortality rates. For incidence, epidemiological factors decreased incidence among females but increased it among males. For mortality rates, epidemiological factors had a moderating influence on both sexes. Joinpoint analysis highlighted periods of rapid urbanization and economic growth pivotal as moments for the surge in incidence and prevalence. Bayesian APC models project a continued rise in incidence rates through 2030. Male incidence rates remain consistently higher than female rates throughout the prediction period, indicating a greater burden of CLL among males.