Epidemiology of Leukaemia by Ethnicity in Aotearoa New Zealand — The Association Specialists
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  2. Oral Presentations - Equity in cancer
  3. Epidemiology of Leukaemia by Ethnicity in Aotearoa New Zealand

Epidemiology of Leukaemia by Ethnicity in Aotearoa New Zealand (23818)

Vicki Lee 1 , Kathryn Bradbury 1 , Vanessa Selak 1 , Alana Cavadino 1
  1. The University of Auckland, Greenlane, AUCKLAND, New Zealand

Background: Leukaemia represents a significant health burden in Aotearoa New Zealand (NZ) but it is unclear whether the burden varies by ethnicity.

Methods: National incidence, mortality, and survival of leukaemia and its main subtypes (acute lymphoblastic/myeloid [ALL, AML], chronic lymphocytic/myeloid [CLL, CML]) were estimated by prioritised ethnicity (Māori, Pacific, Asian, European) among individuals diagnosed between 2007-2022 using data from the NZ Cancer Registry. Age-sex-standardised incidence and mortality rates were calculated per 100,000 population, using a health user contact denominator. Leukaemia-specific survival by ethnicity was examined using Kaplan-Meier and Cox proportional hazards models.  Hazard ratios (HR) were adjusted for age, sex, socioeconomic deprivation, rurality, region, and comorbidity.

Results: A total of 11,375 individuals diagnosed with leukaemia were identified. Māori had the highest overall incidence (14.59, 95%CI 13.72-15.46), and mortality rates (6.89, 6.22-7.61) as well as for all subtypes. Overall incidence was similar for Pacific peoples (12.05, 11.7-7-12.35) and Europeans (12.05, 11.7-7-12.35), and lower for Asian peoples (7.42, 6.74-8.10). Mortality rates for Pacific people (5.87, 5.01-6.83) were higher than European (4.63, 4.46-4.81) and Asian populations (2.79, 2.34-3.30). Leukaemia-specific mortality was higher among Māori than Europeans across all subtypes, although this not statistically significant for ALL (ALL: HR 1.14, 95% CI 0.78-1.68; AML: 1.23, 1.05-1.45; CLL: 1.94, 1.37-2.74; CML: 1.23, 1.05-1.45). Leukaemia-specific mortality for Asian and Pacific peoples was not statistically significantly different to that for Europeans, but confidence intervals were wide and point estimates were higher for Asian peoples with ALL (1.39, 0.84-2.29) and Pacific peoples with CLL (1.90, 0.77-4.71).

Conclusion: The burden of leukaemia in NZ varies by ethnicity, with Māori experiencing the greatest burden, and indications that Pacific and Asian peoples may also experience inequities compared with Europeans. Further research is needed to enhance models of care for Māori and other ethnic groups in NZ.