Introduction:

Multiple myeloma contributes to cancer-related morbidity and mortality in the United States accounting for about 2% of cancer related deaths every year. However, with the advent of targeted therapeutics, the overall survival of myeloma has increased over the years. Nevertheless, access to novel therapeutics is not uniform across different states of the nation. In this study, we aim to analyze the incidence, mortality, and trends in multiple myeloma from 1991 to 2021, with a focus on trends at both the national and state levels along with sex-based disparities.

Methods:

TheGlobal Burden of Disease database was used to extract age-standardized incidence (ASIR), age standardized mortality rates (ASMR), and disability-adjusted life years (DALYs) of multiple myeloma from 1991 to 2021 for both males and females across all states of the United States. Mortality-to-incidence indices (MIIs) were calculated using the ratio of incidence and mortality rates. Disparities related to gender, geography, and time were analyzed and trends were analyzed using joinpoint regression analysis.

Results:

The ASIR of multiple myeloma in the United States decreased by 10.33% between 1991 and 2021, with a more significant decline in females (15.95%) compared to males (8.18%). Similarly, ASMR for both sexes combined fell by 14.61%, with a more substantial decrease in females (18.52%) than in males (13.5%). Overall, the MIIs decreased by 4.78%. The DALYs for both sexes combined declined by 23.03%, with a larger reduction observed in females (26.26%) compared to males (21.79%).

There were notable variations in these trends across states over the 30-years. Changes in ASIR ranged from a 45.62% increase in Kansas to a 49.23% decrease in New Hampshire. ASMR decreased for both sexes in all states from 1991 to 2021, varying from a 1.14% decrease in Oklahoma to a 32.37% decrease in the District of Columbia. DALYs decreased in all states, ranging from a 37.54% reduction in the District of Columbia to 8.05% reduction in New Mexico.

Conclusion:

This analysis highlights gender-based and region-based disparities in the United States in multiple myeloma morbidity and mortality. While the prognosis for multiple myeloma has significantly improved over the years due to therapeutic advances, there has been a significant difference in health indices such as DALYs and ASMR across genders and regions respectively. These findings enhance our understanding of the gender and state level disparities of multiple myeloma underscoring the importance of targeted studies to explore the reasons behind these epidemiological differences.

Disclosures

No relevant conflicts of interest to declare.

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2024
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