Epidemiological and clinical trends in common hematological malignancies in Arkansas: Arkansas Central Cancer Registry (ACCR)-based study.

Abstract

e22579 Background: Arkansas ranks fifth among the US states with the highest cancer mortality rate. Since Arkansas is not a part of the Surveillance, Epidemiology, and End Results (SEER) program, the trends in malignancies in Arkansas are not well elucidated. In this study, we explored the trends in common hematologic malignancies, including multiple myeloma (MM), diffuse large B-cell lymphoma (DLBCL), acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML) in Arkansas. Methods: We retrospectively collected data on these malignancies from 1997 to 2021 using the ACCR database. Annual incidence rates of these malignancies were calculated using population data from the US Census Bureau. Descriptive statistical analyses were performed, and the local trends were compared with the nationwide trends from the SEER database using the Chi-square test. Results: The annual incidence of these malignancies increased from 19.1 per 100,000 in 1997 to 30.3 per 100,000 population in 2021, an increase of 1.9% per year. The annual incidence of MM nearly doubled from 4.4 per 100,000 in 1997 to 8.02 per 100,000 population in 2021 (increased by 82%). This was followed by CLL (3.8 to 6.6 per 100,000, 71% increase), CML (1.1 to 1.8 per 100,000, 63% increase), AML (3.3 to 5.3 per 100,000, 60% increase), ALL (1.0 to 1.5 per 100,000, 46% increase), and DLBCL (5.4 to 7.1 per 100,000, 32% increase). The male-to-female ratio was stable over this time period, with males accounting for 56.9% of all cases. Caucasians and African Americans (AA) accounted for 84.7% and 12.9%, respectively, of all the cases. AA had a disproportionately higher burden of MM, with 23.5% of all MM cases occurring in AA. Between 2010 and 2021, only 52.5–64.4% of these patients received chemotherapy. The treatment rates were highest for ALL (90.1%) and lowest for CLL (17.6%). Conclusions: The incidence of common hematologic malignancies in Arkansas is on the rise, either due to a true increase in cancer rates or enhanced detection. Despite the rising incidence rates, the treatment rates have remained below 65%. The treatment rates in Arkansas are better for CLL and MM and worse for DLBCL and CML compared to the SEER program population. This study highlights the need for similar localized studies worldwide to assess regional trends and implement targeted public health interventions, ensuring equitable access to effective treatments across demographic groups. Cancer Percentage of all cases Patients treated with chemotherapy (%) SEER (2000-2021) Arkansas (1997-2021) P-value SEER (2010-2021) Arkansas (2010-2021) P-value AML 16.8 15.6 <0.01 69.2 67.7 0.20 DLBCL 26.3 26.5 0.58 77.2 75.2 0.01 ALL 6.3 4.9 <0.01 91.7 90.1 0.21 CML 3.4 7.1 <0.01 70.4 65.8 <0.01 CLL 22.0 19.8 <0.01 14.2 17.6 <0.01 MM 25.2 26.1 0.01 59.2 61.5 0.01 All cases 100 100 - 57.4 58.8 <0.01