Multiple Myeloma Incidence and Mortality Around the Globe; Interrelations Between Health Access and Quality, Economic Resources, and Patient Empowerment

Abstract

Background. The interrelation between the worldwide incidence, mortality, and survival of patients with multiple myeloma (MM) and relevant factors such as Health Care Access and Quality (HAQ) index, gross domestic product (GDP), health care expenditures, access to cancer drugs, and patient empowerment has not been addressed before. Material and Methods. Epidemiologic data were obtained from the International Agency for Research on Cancer. The mortality-to-incidence ratio (expressed as 1-MIR) was used as proxy for 5-year survival. Information on health expenditure was obtained from Bloomberg Health-Care Efficacy ranking, the HAQ Index was used as a measure of available health care. For patient empowerment, visits to the Web site of the International Myeloma Foundation were used as proxy. Data on GDP and population per country were assessed from the International Monetary Fund and the United Nations Population Division, respectively. Possible associations were analyzed using Spearman's rank-order correlation. Results. The worldwide incidence of MM is currently 160,000, and mortality is 106,000. Age-standardized myeloma incidence varies between 0.54 and 5.3 per 100,000 and correlates with 1-MIR, patient empowerment, HAQ Index, and access to cancer drugs. The 1-MIR varies between 9% and 64% and is closely related to myeloma incidence, HAQ Index, patient empowerment, access to cancer drugs, and health care expenditures. Conclusion. The global incidence and outcome of MM shows significant disparities, indicating under-recognition and suboptimal treatment in many parts of the globe. Results also highlight the importance of economic resources, access to and quality of health care, and patient education for improving diagnosis and survival of patients with MM. The Oncologist 2020;25:1-8 Implications for Practice: Multiple myeloma accounts for 10% of all hematological malignancies and has moved to the forefront of clinical interest because of the significant advances in medical treatment. Diagnosis depends on laboratory tests, imaging, and professional expertise, particularly in patients without a significant M-component. The present data show a substantial worldwide variation in incidence and mortality, that is mainly due (apart from variations due to ethnicity and lifestyle) to disparities in access to and quality of health care, a parameter strongly related to the economic development of individual countries. Improvement of quality of care and, consequently, in outcome is associated with patient empowerment.

Plasmacytoma and plasma cell myeloma affecting the jaws: A multi‐institutional collaborative study

“…Plasma cell neoplasms account for approximately 10% of all malignant haematolymphoid tumours, representing the second most common intra-osseous malignancy after osteosarcomas. 1,3,4 The gnathic bones can be affected in up to 30% of the cases, usually in the posterior region and ascending ramus of the mandible, 12 and these lesions may be the first finding that leads to the diagnosis of the disease. [10][11][12] In the present series, we described the clinicopathological and radiographic features of a large series of patients affected by plasma cell neoplasms that were diagnosed by microscopic examination, demonstrating the importance of gnathic lesions for the diagnosis of plasma cell neoplasms.…”

“…[1][2][3] The International Agency for Research on Cancer estimated for 2018 a total of 160 000 new cases worldwide, and 106 000 deaths. 4 Plasmacytomas are localized monoclonal plasma cell lesions, with no evidence of systemic involvement, 1 that can be classified as solitary bone plasmacytoma or extramedullary solitary plasmacytoma (when affecting soft tissues). [3][4][5] In the head and neck region, plasmacytomas most commonly affect the skull and jaw bones; however, 6,7 more than 50% of these patients will develop PCM within 2 years after their initial diagnosis, with involvement of multiple sites.…”

“…9,10 In addition, patients generally show systemic alterations such as anaemia, hypercalcaemia, chronic renal failure, fatigue, weakness and amyloidosis, among others. 3,4 The diagnosis of plasmacytomas/ PCM in the oral and maxillofacial regions may be difficult given the low frequency and eventual first clinical manifestation of the disease. 10,11 Hence, recognition of the clinical, radiographic and microscopic manifestations of this neoplasm is of great importance for head and neck surgeons, dentists and oral pathologists to make a correct diagnosis.…”

“…Plasma cell neoplasms are characterized by the neoplastic proliferation of a single clone of plasma cells with the production of monoclonal immunoglobulins that may manifest as single (plasmacytoma) or multiple lesions (plasma cell myeloma [PCM]) 1‐3 . The International Agency for Research on Cancer estimated for 2018 a total of 160 000 new cases worldwide, and 106 000 deaths 4 …”

The Immunity‐malignancy equilibrium in multiple myeloma: lessons from oncogenic events in plasma cells

“…Multiple myeloma (MM) is a malignancy of plasma cells (PCs), that expand and accumulate within the bone marrow (BM), leading to renal damage, anemia and bone lesions. It accounts for 10%-15% of all hematological cancers, with a worldwide incidence of around 160,000 cases and 100,000 deaths per year [1]. The median age at diagnosis is around 65 years and, despite recent advances in therapeutic regimens, 5-year survival rate is still of approximately 50 %, urging to pursue a better understanding of disease biology to develop new effective treatments.…”