Incidence and mortality of multiple myeloma: Global, regional and national estimates and projections from the Global Burden of Disease Study 2021

Multiple myeloma (MM), the second most common haematological malignancy, remains incurable to date. Based on Global Burden of Disease 2021, global trends in MM incidence, mortality and disability-adjusted life-years (DALYs) were analysed and visualized. Estimated annual percentage changes (EAPCs) quantified trends and future disease burden (2022-2050) were forecasted using autoregressive integrated moving average time-series models. From 1990 to 2021, the global burden of MM incidence showed a slight increase, primarily affecting ageing populations and high/high-middle sociodemographic index (SDI) regions. This rise was more significant in males and notably in middle SDI regions (including East Asia, Central Asia and Western Sub-Saharan Africa). Mortality trends exhibited minimal overall growth; female age-standardized death rates (ASDRs) decreased, especially in high SDI regions. Across 204 countries and 21 SDI regions, MM ASDRs correlated positively with SDI, while EAPCs correlated negatively with Human Development Index (HDI), age-standardized incidence rates (ASIRs) and ASDRs. Projections indicate rising ASIRs for both sexes and increasing ASDRs and age-standardized DALY rates among males through 2050. Additionally, population-attributable fractions of MM deaths and DALYs due to high body mass index showed upward trends across all SDI regions from 1990 to 2021. Over three decades, global MM incidence has moderately increased, most affecting ageing populations and high/high-middle SDI regions. Notably, global mortality and DALY rates have declined since 2000, especially in females and high SDI regions. Initiatively, our study identified a significant negative correlation between the HDIs and EAPCs of MM incidence and mortality and takes SDI as the core external predictor to project the global MM disease burden up to 2050.