Descriptive Epidemiology

Table 2-1 gives comparable age-standardized incidence rates from cancer registries covering registration periods around 1990.1 Even bearing in mind the caveats in the introduction, it seems clear that the condition is roughly twice as common in men and that rates vary considerably throughout the world.

The only reported exception to the male preponderance is from West Africa, where CLL in women aged 35 to 50 appears to be more common and that may be, in fact, prolymphocytic leukemia (PLL).2

The highest rates of CLL occur in Europe and in European populations in North America and Australasia. Lower rates occur in Polynesia, sub-Saharan Africa, and South and East Asia. The lowest recorded rates come from Japan. The Japanese data are likely to be accurate, being based on sound recording protocols. This 30-fold variation in national rates has led to many investigations as to the genetic basis of risk (see later).

Table 2-2 gives the typical European age and sex profile.3 The number of cases under the age of 30 is very low (and unreliable) whereas there is an 80-fold increase in males in incidence from the 30 to 34 year age group to the 75 to 79 year age group. The equivalent change in Japan is roughly sixfold, with the rates for the 30 to 34 year age band being similar between Asia and Europe but a smaller rise with age occurs in Japan compared with the massive increase in Europe.

Table 2-1. Age-Standardized World Incidence Rates of

Chronic Lymphocytic Leukemia (CLL) and Chronic Myeloid

Leukemia (CML)a

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