TY - JOUR
T1 - Global burden of multiple myeloma
T2 - A systematic analysis for the global burden of disease study 2016
AU - Cowan, Andrew J.
AU - Allen, Christine
AU - Barac, Aleksandra
AU - Basaleem, Huda
AU - Bensenor, Isabela
AU - Curado, Maria Paula
AU - Foreman, Kyle
AU - Gupta, Rahul
AU - Harvey, James
AU - Dean Hosgood, H.
AU - Jakovljevic, Mihajlo
AU - Khader, Yousef
AU - Linn, Shai
AU - Lad, Deepesh
AU - Mantovani, Lorenzo
AU - Nong, Vuong Minh
AU - Mokdad, Ali
AU - Naghavi, Mohsen
AU - Postma, Maarten
AU - Roshandel, Gholamreza
AU - Shackelford, Katya
AU - Sisay, Mekonnen
AU - Nguyen, Cuong Tat
AU - Tran, Tung Thanh
AU - Xuan, Bach Tran
AU - Ukwaja, Kingsley Nnanna
AU - Vollset, Stein Emil
AU - Weiderpass, Elisabete
AU - Libby, Edward N.
AU - Fitzmaurice, Christina
N1 - Publisher Copyright:
© 2018 American Medical Association. All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - INTRODUCTION Multiplemyeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden ofMMis needed to help direct health policy, resource allocation, research, and patient care. OBJECTIVE To describe the burden ofMMand the availability of effective therapies for 21 world regions and 195 countries and territories from 1990 to 2016. DESIGN AND SETTING We report incidence, mortality, and disability-Adjusted life-year (DALY) estimates from the Global Burden of Disease 2016 study. Data sources include vital registration system, cancer registry, drug availability, and survey data for stem cell transplant rates.We analyzed the contribution of aging, population growth, and changes in incidence rates to the overall change in incident cases from 1990 to 2016 globally, by sociodemographic index (SDI) and by region.We collected data on approval of lenalidomide and bortezomib worldwide. MAIN OUTCOMES AND MEASURES Multiplemyeloma mortality; incidence; years lived with disabilities; years of life lost; and DALYs by age, sex, country, and year. RESULTS Worldwide in 2016 there were 138 509 (95%uncertainty interval [UI], 121 000-155 480) incident cases ofMMwith an age-standardized incidence rate (ASIR) of 2.1 per 100 000 persons (95%UI, 1.8-2.3). Incident cases from 1990 to 2016 increased by 126% globally and by 106%to 192%for all SDI quintiles. The 3 world regions with the highest ASIR ofMMwere Australasia, North America, andWestern Europe. Multiplemyeloma caused 2.1 million (95%UI, 1.9-2.3 million) DALYs globally in 2016. Stem cell transplantation is routinely available in higher-income countries but is lacking in sub-Saharan Africa and parts of the Middle East. In 2016, lenalidomide and bortezomib had been approved in 73 and 103 countries, respectively. CONCLUSIONS AND RELEVANCE Incidence ofMMis highly variable among countries but has increased uniformly since 1990, with the largest increase in middle and low-middle SDI countries. Access to effective care is very limited in many countries of low socioeconomic development, particularly in sub-Saharan Africa. Global health policy priorities forMMare to improve diagnostic and treatment capacity in low and middle income countries and to ensure affordability of effective medications for every patient. Research priorities are to elucidate underlying etiological factors explaining the heterogeneity inmyeloma incidence.
AB - INTRODUCTION Multiplemyeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden ofMMis needed to help direct health policy, resource allocation, research, and patient care. OBJECTIVE To describe the burden ofMMand the availability of effective therapies for 21 world regions and 195 countries and territories from 1990 to 2016. DESIGN AND SETTING We report incidence, mortality, and disability-Adjusted life-year (DALY) estimates from the Global Burden of Disease 2016 study. Data sources include vital registration system, cancer registry, drug availability, and survey data for stem cell transplant rates.We analyzed the contribution of aging, population growth, and changes in incidence rates to the overall change in incident cases from 1990 to 2016 globally, by sociodemographic index (SDI) and by region.We collected data on approval of lenalidomide and bortezomib worldwide. MAIN OUTCOMES AND MEASURES Multiplemyeloma mortality; incidence; years lived with disabilities; years of life lost; and DALYs by age, sex, country, and year. RESULTS Worldwide in 2016 there were 138 509 (95%uncertainty interval [UI], 121 000-155 480) incident cases ofMMwith an age-standardized incidence rate (ASIR) of 2.1 per 100 000 persons (95%UI, 1.8-2.3). Incident cases from 1990 to 2016 increased by 126% globally and by 106%to 192%for all SDI quintiles. The 3 world regions with the highest ASIR ofMMwere Australasia, North America, andWestern Europe. Multiplemyeloma caused 2.1 million (95%UI, 1.9-2.3 million) DALYs globally in 2016. Stem cell transplantation is routinely available in higher-income countries but is lacking in sub-Saharan Africa and parts of the Middle East. In 2016, lenalidomide and bortezomib had been approved in 73 and 103 countries, respectively. CONCLUSIONS AND RELEVANCE Incidence ofMMis highly variable among countries but has increased uniformly since 1990, with the largest increase in middle and low-middle SDI countries. Access to effective care is very limited in many countries of low socioeconomic development, particularly in sub-Saharan Africa. Global health policy priorities forMMare to improve diagnostic and treatment capacity in low and middle income countries and to ensure affordability of effective medications for every patient. Research priorities are to elucidate underlying etiological factors explaining the heterogeneity inmyeloma incidence.
UR - http://www.scopus.com/inward/record.url?scp=85053397909&partnerID=8YFLogxK
U2 - 10.1001/jamaoncol.2018.2128
DO - 10.1001/jamaoncol.2018.2128
M3 - Article
C2 - 29800065
AN - SCOPUS:85053397909
SN - 2374-2437
VL - 4
SP - 1221
EP - 1227
JO - JAMA Oncology
JF - JAMA Oncology
IS - 9
ER -
