Distribution and Incidence

Leukemia occurs worldwide and represents just over 5 percent of all cancers. The disease does not present in a regular pattern, and its comparative rarity helps to explain its irregularity. Leukemia can strike anyone, at any time, and at any age. The difficulties in collecting statistics relating to leukemia in populations throughout the world are due not only to the different methods of reporting cases and identifying the true leukemia cell-type specificity, but also to the variable standards and access to medical care. Comparing the incidence of leukemia and other cancers on a worldwide basis can therefore present problems.

The specific types of leukemia are very different in their age patterns and presentation:

1. Acute myeloid leukemia (AML) is the major form of leukemia. Its rate of incidence increases with age, yet it also occurs in early infancy and in those in their early 20s. With a mean estimated presentation at around the age of 40 years, the disease affects both sexes equally.

2. Chronic myeloid leukemia (CML) is considered an "adult" leukemia, attacking those in the 30- to 50-year age bracket, although it also presents in the older age groups. It, too, has an equal rate of incidence in males and females.

3. Acute lymphoblastic leukemia (ALL) is often referred to as "childhood leukemia" for the reason that it accounts for 85 percent of leukemia in children and only 15 percent of cases in adults. ALL has been reported in all races and all geographic areas; yet, for every child with leukemia there are about 10 adults with it.

4. Chronic lymphocytic leukemia (CLL) is primarily a disease of the elderly; it rarely presents in anyone below the age of 40. It is more common in males than females, with a male/female ratio of 2:1.

The estimated incidence of all cases of leukemia in the developed countries of the world is 10 per 100,000 of population, the most common now being CLL including the lymphoproliferative disorders, followed by AML and its subgroups, then CML, and lastly ALL. Incidence rates vary in some countries of the world and among some ethnic groups, but no variation is of great significance. The male/female incidence ratio is about 1.7:1.

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