Global Burden and Trends of Acute Myeloid Leukemia Attributable to High Body Mass Index in 38 OECD Countries between 1990-2019: A Benchmarking Systematic Analysis for the Global Burden of Disease Study 2019

Background: Acute myeloid leukemia (AML) is a significant cause of mortality and disability, ranking 17th among leading causes of death and 15th among leading causes of disability among all cancers in Organization for Economic Co-operation and Development (OECD) countries. Current evidence suggests a potential association between a high body mass index (BMI) and an increased risk of AML and other cancers. However, the impact of high BMI on AML burden may vary due to factors such as geographical location, lifestyle, genetic predisposition, and changes in obesity rates over time. This study aimed to assess the burden of AML attributable to high BMI in 38 OECD countries from 1990 to 2019.

Method: The methodology employed the Global Burden of Disease approach, analyzing AML deaths and disability-adjusted life years (DALYs) attributable to high BMI across age groups, sexes, and years in the 38 OECD countries using standardized methods and statistical modeling. The results were reported in absolute counts and age-standardized rates (per 100,000 person-years).

Results: The study found that the total number of AML deaths attributable to high BMI increased from 1,625 (95% uncertainty interval (UI): 726-2,831) in 1990 to 4,295 (95% UI: 2,094-7,105) in 2019, while DALYs increased from 43,467 (95% UI: 19,649-75,434) to 96,289 (95% UI: 47,925-157,090) between 1990 and 2019. The age-standardized mortality rate (ASMR) rose from 0.13 (95% UI: 0.06-0.22) to 0.19 (95% UI: 0.09-0.31) cases per 100,000 during the same period, and the age-standardized DALYs rate (ASDALR) increased from 3.47 (95% UI: 1.57-6) to 4.83 (95% UI: 2.43-7.83) cases per 100,000 persons.

Notably, Colombia experienced the highest increase in the annual percentage of change (APC) in total AML deaths (474%), followed by South Korea (398%), and Costa Rica (315%), while Latvia showed the lowest increase of 16% from 1990 to 2019. Concerning DALYs, Colombia had the highest APC increase (391%), followed by Costa Rica (268%) and Mexico (246%), while Latvia observed a 2% decrease in APC from 1990 to 2019. Switzerland and Denmark showed decreases in APC for ASMR (6% and 9%, respectively) from 1990 to 2019, and Finland, Japan, Denmark, and Switzerland demonstrated decreases in APC for ASDALR (4%, 6%, 18%, and 20%, respectively). The United States reported the highest number of AML deaths (1,575) and DALYs (35,063) attributable to high BMI in 2019. Individuals aged 70-74 years had the highest number of deaths (709, 95% UI: 356-1,168) and DALYs (13,762, 95% UI: 6,939-22,564) in 2019 in OECD countries. Additionally, males showed higher deaths and DALYs compared to females due between 1990 and 2019.

Conclusion: The burden of AML attributed to high BMI has continued to rise in the majority of countries over the past three decades. As obesity is a modifiable risk factor, effective preventive strategies, counseling for high-risk individuals, and coordinated efforts by healthcare professionals and policymakers are essential to implement interventions across OECD countries. Given obesity's significance as a modifiable risk factor for various cancers, urgent action is needed to address this public health challenge.