Figure 1 shows the ASMRs per 100,000 person-years in children from 15 LAC countries between 2013 and 2017. Venezuela, Ecuador, Nicaragua, Mexico, and Peru reported the highest mortality rates in boys (above 2 deaths per 100,000 persons-years), while Nicaragua, Ecuador, and Mexico reported the highest mortality rates in girls (above 2 deaths per 100,000 persons-years). The lowest mortality rates were reported in Uruguay and Puerto Rico for both sexes (below 1 death per 100,000 persons-years).
Figure 2 illustrates the percent changes between the periods 2000–2005 and 2012–2017 in LAC countries. Most countries reported decreases, mainly in boys. The greatest decreases were reported in Venezuela (−60% in boys and −55% girls), Puerto Rico (−69% in boys and −43% in girls), and Uruguay (−63% in boys and −22% in girls). Some differences by sex were reported in Panama, Nicaragua, Peru, Costa Rica, Ecuador, and Guatemala. For instance, Panama declined by 12.6% among boys, but increased by 34.9% among girls, Nicaragua declined by 7.8% among boys, but increased by 26.6% among girls, and Peru declined by 21.4% among boys, but increased 19.3% among girls (See Supplementary 1).
In boys, Nicaragua (EAPC= 2.9, 95% CI: 0.5, 5.3, p<0.05)and Peru (EAPC=1.4, 95% CI: 0.3, 2.5, p<0.05) had significant upward trends in whole period, whereas Puerto Rico (EAPC=−14.8, 95% CI: −25.4, −2.8, p<0.05) and Uruguay (EAPC=−4.4, 95% CI: −7.3, −1.3, p<0.05) experienced downward trends. Whereas in girls, only Peru had an upward trend (EAPC=1.4, 95% CI: 0.1, 2.8, p<0.05), while, three countries showed downward trends, Puerto Rico (EAPC=−8.8, 95% CI: −16.4, −0.5, p<0.05) experienced the greatest reduction, followed by Uruguay (EAPC=−7.4, 95% CI: −14.7, −0.3, p<0.05) and Mexico (EAPC=−0.7, 95% CI: −1.3, −0.1, p<0.05) (Figure 3, Figure 4, and Supplementary 2).
Table 1 shows the number of projected leukemia deaths in boys, age-standardized mortality rates and percentage change in deaths due to population and risk between 2015 and 2030. The forecast indicates that mortality rates will increase in Argentina, Brazil, Chile, Ecuador, Guatemala, Mexico, Peru, Puerto Rico, and Uruguay; and decline in Costa Rica, Cuba, Nicaragua, Panama, and Paraguay. The evaluation of change due to risk between 2015 and 2030, among boys, found a pronounced increase in Argentina (+21.8%), Uruguay (+29.8%), and Ecuador (+31.8%). The predicted total reduction in rates in Puerto Rico (−56.7%) would be predominantly due to population change (−58.7%), despite an increase in the risk of leukemia mortality (+2.1%). Ecuador is forecast to have an increase in population (+5.8%) and risk of death (+31.8%), resulting in an overall increase for leukemia mortality (+37.6%).
Among girls, mortality rates will potentially increase in most LAC countries. In addition, there will be an increase in the risk of leukemia mortality in Argentina, Chile, Cuba, Ecuador, Nicaragua, Peru, Puerto Rico, and Uruguay which was the basis for the predicted increase among all the countries (except for a decline in Chile of 4.9%). For Cuba, and Puerto Rico, there will a reduction in mortality resulting from changes in population structure and size, whereas in Brazil, Costa Rica, and Mexico there will be a reduction in mortality due to both population changes and a decrease in the risk of leukemia mortality (Table 2).