Background

Multiple myeloma accounted for 176 404 (14%) of 1 278 362 the incidence cases leukaemia, lymphoma, and multiple myeloma in 2020. Identifying its geographical distribution, risk factors, and epidemiological trends could help identify high-risk population groups. We aimed to examine the worldwide incidence, mortality, associated risk factors, and temporal trends of multiple myeloma by sex, age, and geographical region.

Methods

The incidence and mortality of multiple myeloma were extracted from Global Cancer Observatory (2020), Cancer Incidence in Five Continents, WHO mortality database, Nordic Cancer Registries, and Surveillance, Epidemiology, and End Results Program (1980–2019). The WHO Global Health Observatory data repository was searched for the age-standardised prevalence of lifestyle and metabolic risk factors (2010). Associations with risk factors were examined by multivariable regression. The temporal trends were evaluated by average annual percentage change (AAPC) using joinpoint regression.

Findings

The age-standardised rate (ASR) of multiple myeloma incidence was 1·78 (95% UI 1·69–1·87) per 100 000 people globally and mortality was 1·14 (95% UI 1·07–1·21) per 100 000 people globally in 2020. Increased incidence and mortality were associated with higher human development index, gross domestics product, prevalence of physical inactivity, overweight, obesity, and diabetes. Australia and New Zealand (ASR 4·86 [4·66–5·07]), northern America (4·74 [4·69–4·79]), and northern Europe (3·82 [3·71–3·93]) reported the highest incidence. The lowest incidences were observed in western Africa (0·81 [0·39–1·66]), Melanesia (0·87 [0·55–1·37]), and southeastern Asia (0·96 [0·73–1·27]). Overall, more countries had an increase in incidence, especially in men aged 50 years or older. The countries with the highest incidence increase in men older than 50 years were Germany (AAPC 6·71 [95% CI 0·75–13·02] p=0·027), Denmark (3·93 [2·44–5·45] p=0·00027), and South Korea (3·25 [0·69–5·88] p=0·019). For women aged 50 years or older, Faroe Islands (21·01 [2·15–43·34] p=0·032), Denmark (4·70 [1·68–7·82], p=0·0068), and Israel (2·57 [0·74–4·43] p=0·012) reported the greatest increases. Overall, there was a decreasing trend for multiple myeloma mortality. The highest mortality was observed in Polynesia (ASR 2·69 [0·74–9·81]), followed by Australia and New Zealand (1·84 [1·73–1·96]) and northern Europe (1·80 [1·73–1·88]). The lowest mortalities were reported in southeastern Asia (ASR 0·82 [0·62–1·09]), eastern Asia (0·76 [0·71–0·81]), and Melanesia (0·73 [0·61–0·87]). Men (1·41 [1·29–1·53]) were found to have mortality higher than women (0·93 [0·85–1·02]).

Interpretation

There was an increasing trend of multiple myeloma incidence globally, particularly in men, people aged 50 years or older, and those from high-income countries. The overall decreasing global trend of multiple myeloma mortality was more evident in women. Lifestyle habits, diagnosis capacity, and treatment availability should be improved to control the increasing trends of multiple myeloma in high-risk populations. Future studies should explore the reasons behind these epidemiological transitions.

Funding

None.

中文翻译：

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多发性骨髓瘤的流行病学概况：全球癌症登记处对疾病负担、风险因素和时间趋势的估计

背景

多发性骨髓瘤占 2020 年 1 278 362 例白血病、淋巴瘤和多发性骨髓瘤发病率的 176 404 例（14%）。确定其地理分布、危险因素和流行病学趋势有助于确定高危人群。我们旨在按性别、年龄和地理区域检查多发性骨髓瘤的全球发病率、死亡率、相关危险因素和时间趋势。

方法

多发性骨髓瘤的发病率和死亡率来自全球癌症观察站 (2020)、五大洲的癌症发病率、世卫组织死亡率数据库、北欧癌症登记处以及监测、流行病学和最终结果计划 (1980-2019)。搜索了世卫组织全球卫生观察站数据存储库，以了解生活方式和代谢危险因素的年龄标准化患病率（2010 年）。通过多变量回归检查与风险因素的关联。使用联合点回归通过平均年百分比变化 (AAPC) 评估时间趋势。

发现

全球多发性骨髓瘤发病率的年龄标准化率 (ASR) 为 1·78 (95% UI 1·69–1·87) 每 100 000 人，死亡率为 1·14 (95% UI 1·07–1·21) ) 2020 年全球每 10 万人。发病率和死亡率的增加与人类发展指数、国内生产总值、缺乏身体活动的流行、超重、肥胖和糖尿病有关。澳大利亚和新西兰 (ASR 4·86 [4·66–5·07])、北美 (4·74 [4·69–4·79]) 和北欧 (3·82 [3·71–3 ·93]) 报告的发病率最高。西非 (0·81 [0·39–1·66])、美拉尼西亚 (0·87 [0·55–1·37]) 和东南亚 (0·96 [0·73]) 的发病率最低。 –1·27]）。总体而言，更多国家的发病率增加，尤其是 50 岁或以上的男性。50 岁以上男性发病率增幅最高的国家是德国 (AAPC 6·71 [95% CI 0·75–13·02] p=0·027)、丹麦 (3·93 [2·44–5 ·45] p=0·00027）和韩国（3·25 [0·69–5·88] p=0·019）。对于 50 岁或以上的女性，法罗群岛 (21·01 [2·15–43·34] p=0·032)、丹麦 (4·70 [1·68–7·82], p=0·0068 )，而以色列 (2·57 [0·74–4·43] p=0·012) 报告的增幅最大。总体而言，多发性骨髓瘤死亡率呈下降趋势。波利尼西亚的死亡率最高（ASR 2·69 [0·74–9·81]），其次是澳大利亚和新西兰（1·84 [1·73–1·96]）和北欧（1·80 [1·73–1·88]）。东南亚 (ASR 0·82 [0·62–1·09])、东亚 (0·76 [0·71–0·81]) 和美拉尼西亚 (0·73 [0· 61-0·87]）。

解释

全球多发性骨髓瘤发病率呈上升趋势，尤其是男性、50 岁或以上人群以及来自高收入国家的人群。全球多发性骨髓瘤死亡率总体下降趋势在女性中更为明显。应提高生活习惯、诊断能力和治疗可及性，以控制高危人群多发性骨髓瘤的增加趋势。未来的研究应该探索这些流行病学转变背后的原因。

资金

没有任何。