Epidemiological trends and burden projections of childhood leukemia in China: age-stratified analysis and impact of COVID-19 from 1990 to 2035.

To analyze the incidence, mortality, and disease burden (disability-adjusted life year, DALY rate) of leukemia in children aged 0–14 years in China from 1990 to 2021. Based on the Chinese leukemia surveillance data in the Global Burden of Disease database from 1990 to 2021. The Estimated Annual Percentage Change (EAPC) and Bayesian Age–Period–Cohort (BAPC) prediction models were used to evaluate the trends of incidence, mortality and DALY in different strata and predict them to 2035. The EAPC was used to quantify the annual trends of incidence, mortality and DALY rates, and the BAPC model was used to decompose the independent effects of age, period and birth cohort on the burden of disease. The incidence of childhood leukemia in 2021 decreased by 10.8% compared with 1990, together with this, the mortality rate (76.9%) and DALY rate (76.9%) decreased significantly. After the COVID-19 pandemic, the incidence rates in the 1–5 month group and the 6–11 month group increased by 63.7% and 62.5%, respectively, while those in the 12–23 month group and the 2–4 year group decreased by 23.1% and 58.1%, respectively. Acute lymphocytic leukemia accounted for the highest proportion, and the incidence rate in male newborns was higher than that in female newborns. It is predicted that by 2035, the incidence, mortality and DALY rates will further decline. The burden of childhood leukemia is declining overall in China, but attention should be paid to fluctuations in specific age groups and gender differences to optimize early screening and classification treatment programs.