Acute myeloid leukemia (AML) is a common type of leukemia that affects myeloid stem cells that are made into granulocytes, monocytes, and reticulocytes.[1] Treatment has rarely changed in the 20th to 21st century, and many minority communities are undertreated.[1] [2] We aimed to estimate the prevalence of AML using the Surveillance, Epidemiology, and End Results (SEER) database, a recently launched initiative by the Surveillance Research Program in National Cancer Institute's Division of Cancer and Population Sciences,[3] to effect better patient care that is tailored to sociodemographic factors. This study was deemed Institutional Review Board exempt due to its retrospective nature. We performed a cross-sectional analysis of the SEER database by identifying patients with a diagnosis of AML using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 205.0 and ICD-10-CM code C92.00. Electronic medical records of each patient with AML were then analyzed to collect data on age, sex, and self-identified race. SEER provided the overall prevalence of AML based on census data and estimations on populations lost to follow-up. As of 2020, the SEER database has enrolled 43,926,825.00 cases, shown in [Table 1]. We used the latest available data, which encompasses 2017 to 2018 census data, and identified 9,572.8 with AML, representing an overall prevalence of 0.04%. The prevalence was highest in the 70 to 74 age group, increasing with age. Prevalence in specific racial groups included 0.01% in white, 0.01% in black, 0.01% in American Indian/Alaska Native, and 0.01% in Asian or Pacific Islander patients. Furthermore, the SEER database is 71% white, 12% black, American-Indian 2%, and 15% Asian-Pacific Islanders,[4] while the United States population is 76% white, 14% black, 1% American-Indian, and 7% Asian.[5] Thus, our prevalence calculation of AML is an underestimation of the white and black population, and an overestimation of the Hispanic and Asian population. It is also likely that there are more patients that are unaccounted for due to U.S. residency status, health care availability, and limitations of the census. Chi-squared test of independence show that there is no significant difference between the SEER and the U.S. Census population. There was not a significant relationship between the two populations, chi-square (3, N = 304,167,848) = 3,404,209.8855, p < 0.00001 ([Table 2]). This result suggests that these populations are statistically similar and allow an estimation of the U.S. population using SEER. Altogether, our data suggest AML is a common leukemia across all racial groups. Further epidemiologic studies that are not restricted by billing codes may validate our findings. Understanding sociodemographic factors can increase clinical practice diversity and inclusivity to increase diagnosis and treatment among minority populations.
Table 1 Demographic distribution of prevalence percentage and numbers of acute myeloid leukemia, including race and ageGroup
Estimated prevalence percent
Estimated prevalence count
Population at prevalence date
Known alive
Lost
Lost estimated alive
Dead prior to prevalence date
White
0.01%
3,222.8
31,240,899
4,792
563
348.8
19,163
Black
0.01%
543.6
5,224,726
536
46
32.6
1,871
American Indian/Alaska Native
0.01%
74
897,021.5
79
2
1
150
Asian or Pacific Islander
0.01%
842.9
6,564,178.5
799
124
75.9
2,509
Unknown
54.6
0
40
22
14.6
44
00 years at previous date
0.00%
3
522,150
3
0
0
1
01–04 years at previous date
0.00%
79.2
2,159,900.5
86
5
2.2
23
05–09 years at previous date
0.00%
134.3
2,732,193.5
116
21
18.3
51
10–14 years at previous date
0.01%
191
2,786,556.5
160
35
31
74
15–19 years at previous date
0.01%
222.9
2,781,405
204
28
24.9
127
20–24 years at previous date
0.01%
322.5
2,954,646.5
301
24
21.5
189
25–29 years at previous date
0.01%
353.3
3,391,241
328
31
25.3
255
30–34 years at previous date
0.01%
355.6
3,191,280.5
321
42
34.6
286
35–39 years at previous date
0.01%
414.5
3,049,214.5
368
55
46.5
354
40–44 years at previous date
0.01%
460.8
2,779,268.5
398
75
62.8
393
45–49 years at previous date
0.01%
546.7
2,889,978.5
482
78
64.7
517
50–54 years at previous date
0.02%
601.9
2,837,532.5
551
65
50.9
607
55–59 years at previous date
0.02%
615.2
2,873,440
555
71
60.2
891
60–64 years at previous date
0.02%
142
2,591,284.5
642
64
10
1,239
65–69 years at previous date
0.02%
113.9
2,124,581
613
33
5.9
1,574
70–74 years at previous date
0.03%
107.5
1,598,623.5
516
33
6.5
1,954
75–79 years at previous date
0.02%
70.6
1,077,416
300
33
6.6
2,173
80–84 years at previous date
0.00%
0
736,037
194
20
0
2,467
85+ years at previous date
0.00%
3
850,075.5
108
44
1
10,562
Table 2 Chi-square test of independence for SEER and U.S. race proportions estimated in 2018Estimated SEER population in 2018
Estimated U.S. population in 2018
Row totals
White
31,240,899 (33,049,304.38) [98,953.07]
197,606,407 (195,798,001.62) [16,702.57]
228,847,306
Black
5,224,726 (6,661,487.98) [309,883.47]
40,902,223 (39,465,461.02) [52,306.12]
46,126,949
American-Indian
897,022 (478,652.71) [365,678.20]
2,417,371 (2,835,740.29) [61,723.87]
3,314,393
Asian-Pacific Islander
6,564,179 (3,737,380.93) [2,138,071.41]
19,315,021 (22,141,819.07) [360,891.18]
25,879,200
Column totals
43,926,826
2.6E + 8
304,167,848 (grand total)
Abbreviation: SEER, Surveillance, Epidemiology, and End Results.
Note: Observed population in each cell, expected in parentheses, and chi-square statistics in brackets. Chi-square statistic is 3,404,209.8855. The p-value is < 0.00001. The result is significant at p < 0.05.
Received: 10 January 2025
Accepted: 17 January 2025
Article published online:
31 March 2025
© 2025. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Comments (0)