The burden trend and risk factors of multiple myeloma from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021

IMPORTANCE MM was an incurable clonal plasma cell malignancy with substantial prevalence and incidence, which had resulted in a significant burden of disease. Our study aimed to evaluate the global, regional and national burden of MM by sex, age, and SDI from 1990 to 2021, along with associated risk factors and predicted temporal trends.

To assess the global burden, epidemiological trends, and risk factors of MM and project its incidence rate by 2050. Design This is a systematic analysis of the global burden of MM from 1990 to 2021. Setting The study primarily analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of MM from Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2021, by region, age, sex, and SDI. Participants The study builds on findings from the GBD 2021. Exposure Multiple myeloma. Main Outcomes and Measures The Joinpoint regression was used to describe the trends. Two-sample Mendelian randomization (MR) analysis was conducted to identify the causal relationship between weight-related risk factors and MM. The Bayesian age-period-cohort (BAPC) model was used to predict the future trend.

In 2021, the age-standardized prevalence rate (ASPR) of MM was 4.65 (95% UI: 4.21 to 5.01) per 100,000 people, and the age-standardized mortality rate (ASMR) was 1.40 (95% UI: 1.24 to 1.52) per 100,000 people globally. The burden of MM was the highest in the high SDI region, with Monaco and Bahamas reporting the highest age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and ASMR in 2021. Simultaneously, ASRs peaked in the elderly population and were higher in males than in females. GBD 2021 reported high body mass index (BMI) as a risk factor for MM which was further confirmed by two-sample MR analysis. Additionally, BMI, waist circumference, obesity class 1, obesity class 2, overweight and hip circumference were also risk factors for MM. By 2050, the global incidence rate was predicted to decrease slightly but increase within the age group of 20-69.

and Relevance This study found that MM remained a significant public health issue, particularly in high SDI regions and among the elderly. A causal relationship exists between MM and body weight, indicating the need for targeted prevention and intervention strategies in high-risk regions and populations. Competing Interest Statement The authors have declared no competing interest. Funding Statement This work was supported by the National Natural Science Foundation of China [Grant Nos. 31970651, 92046018]; Program for Young Talents of Basic Research in Universities of Heilongjiang Province [Grant No.YQJH2023036]; Marshal Initiative Funding [Grant No. HMUMIF-22010]; Mathematical Tianyuan Fund of the National Natural Science Foundation of China [Grant No. 12026414]. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Original data generated and analyzed during this study are included in this published article or in the data repositories listed in References.