Mortality trends in multiple myeloma and cardiovascular disease in the US (1999–2020).

Abstract

e23056 Background: Multiple Myeloma (MM) and cardiovascular disease (CVD) significantly contribute to mortality in the U.S. This study examines mortality trends from 1999 to 2020, focusing on demographic and geographic disparities. Methods: CDC WONDER data for U.S. adults (≥25 years) from 1999 to 2020 were analyzed. Age-adjusted mortality rates (AAMRs) per million were calculated by gender, race/ethnicity, census region, urbanization level, and state. Joinpoint regression estimated average annual percentage change (AAPC) with 95% confidence intervals (CIs) to assess statistical significance. Results: MM and CVD caused 101,225 deaths, with an overall AAMR of 21.29/million (95% CI 21.16–21.42). AAMRs ranged from 19.72/million (2013) to 23.58/million (2020). The overall trend was stable (AAPC: 0.15%; 95% CI -0.14 to 0.46; p = 0.2807), but mortality increased significantly from 2018–2020 (APC: 6.96%; 95% CI 3.08–9.16; p < 0.000001). Males had higher mortality (56,591 deaths) than females (44,634 deaths). Male AAMRs were 29.33/million (1999) and 28.44/million (2020), while female AAMRs declined from 18.56/million (1999) to 16.25/million (2020). Trends showed a significant decline in females (AAPC: -0.76%; 95% CI -1.28 to -0.37; p < 0.000001) and an increase in males (AAPC: 0.47%; 95% CI 0.27–0.71; p < 0.000001). Racial disparities were evident, with the highest AAMRs in Blacks (45.45/million; 95% CI 44.79–46.10), followed by Whites (19.02/million), Hispanics (19.43/million), and Asians (12.3/million). Mortality declined significantly for Asians (AAPC: -1.52%; 95% CI -2.23 to -0.60; p = 0.0008) and Hispanics (AAPC: -0.72%; 95% CI -1.30 to -0.06; p = 0.038), while trends in Blacks and Whites were not significant. Conclusions: Despite a stable overall trend, male mortality increased, and racial disparities persisted, particularly among Black populations. Targeted interventions are needed to address mortality inequities in high-risk groups. Cohort Age Adjusted Mortality Rate per Million Average Annual Percentage Change 95% Confidence Interval P- Value Overall 21.29 0.1516 -0.1423 to 0.458 0.280744 Female 16.25 -0.7637* -1.2818 to -0.3695 < 0.000001 Male 28.44 0.4728* 0.2666 to 0.7071 < 0.000001 Asian or Pacific Islander 12.3 -1.5233* -2.231 to -0.5963 0.0008 Black or African American 45.45 -0.0821 -0.839 to 0.3407 0.737852 White 19.02 0.2266 -0.0659 to 0.5538 0.111978 Hispanic or Latino 19.43 -0.7208* -1.3047 to -0.0615 0.037992