Temporal trends in the incidence of multiple myeloma in the Middle East and North Africa over the past three decades.

Abstract

Background: Multiple myeloma (MM) is a common hematologic malignancy in aging populations, representing 10% of global hematologic cancers, with higher incidence rates in high-income countries. Studies on MM’s burden in the Middle East and North Africa (MENA) are limited. We hope to help fill this gap in epidemiological trends of MM in the region, which can help inform public health strategies. This study utilizes data from the Global Burden of Disease (GBD) database to analyze temporal trends in MM incidence across the MENA over the past three decades. Methods: Data on age-standardized incidence rates (ASIR) for MM in the MENA from 1990 to 2019 were collected from the GBD database. Joinpoint Analysis software was used to calculate annual percent change (APC) and average annual percent change (AAPC) in ASIR, with stratification by sex and country. Results: From 1990 to 2019, 86,444 MM cases were reported in the MENA, with males representing 56.7% of cases. ASIR increased by an AAPC of 1.55 (95%CI 1.51 to 1.58, p<0.001). Country-specific stratification showed a rise in incidence across most nations, with the most notable increase in Iran (AAPC 2.35, 95%CI 2.32 to 2.38, p<0.001), followed by Saudi Arabia (AAPC 2.19, 95%CI 2.16 to 2.21, p<0.001) and Morocco (AAPC 2.19, 95%CI 2.16 to 2.21, p<0.001). Lebanon had the lowest significant increase (AAPC 0.70, 95%CI 0.65 to 0.75, p<0.001), while Kuwait saw a decrease in ASIR (AAPC -1.1, 95%CI -1.90 to -0.30, p=0.009). Sex-based stratification revealed a significant decline in ASIR for males in Kuwait and Jordan (AAPC -1.01 and -0.11, respectively). For females, ASIR significantly increased in all countries except Kuwait (which experienced a significant decline) and Jordan (which showed no significant change). Conclusions: Our analysis shows a significant increase in MM incidence in the MENA region over the past three decades. This increase could be driven by several factors, including improved healthcare access, better diagnostic capabilities, and longer life expectancies. Countries with higher sociodemographic indices (SDI), like Saudi Arabia, saw a more prominent rise, aligning with global trends. Iran and Morocco, despite having lower SDIs, also experienced significant increases, suggesting that factors beyond SDI may drive these trends. While MM remains male-predominant, ASIR increased in both sexes across most countries, except Kuwait, where both experienced a decline. These findings highlight the need for targeted healthcare strategies to address the growing therapeutic challenges of MM.