Temporal and demographic trends in mortality from multiple myeloma with coexisting mental and behavioral disorders in U.S. adults, 1999–2023.

Abstract

e22592 Background: Multiple myeloma is a plasma cell malignancy with a persistently high mortality rate; when it occurs in patients with mental and behavioral disorders, it negatively affects treatment adherence, disease management, and survival outcomes. In this study, we aimed to discuss the temporal and demographic trends of this comorbidity among the adult population in the United States. Understanding these temporal trends is crucial for identifying vulnerable subgroups, guiding policy, and informing integrated oncologic and mental health care. Methods: Mortality data was obtained from the Centers for Disease Control and Prevention (CDC) WONDER website. International Classification of Disease (ICD-10) code used for multiple myeloma was C90.0 and F01-99 for mental and behavioral disorders. Data were obtained for adults aged 25 years and above. Joinpoint regression was used to calculate APC (Annual Percent Change) and AAPC (Average Annual Percent Change) values per 100,000 population. A p value of less than 0.05 was considered statistically significant. Results: Between 1999 and 2023, multiple myeloma mental and behavioural disorders among adults ≥25 years led to 20,414 deaths, with the most deaths being recorded at medical facilities (31.90%). The AAMR rose from 0.09 in 1999 to 0.49 in 2023 with an associated AAPC of 6.4675* (p < 0.000001). In 1999, men had an AAMR of 0.13, while women had an AAMR of 0.07. This almost increased 5 times in 2023, where men had an AAMR of 0.67 (AAPC: 7.06 p < 0.000001), while women had an AAMR of 0.37 (AAPC: 4.88; p < 0.000001). Black or African American individuals had an AAMR of 1.01 in 2023 (AAPC: 5.1949*, p < 0.000001), which was almost twice as high as the AAMR of White individuals, who experienced an AAMR of 0.46 (AAPC: 6.5591*, p < 0.000001) in 2023. States with the highest AAMRs included Vermont (0.67), Oregon (0.65) and North Dakota (0.63); states with the lowest AAMRs included California (0.17), Alabama (0.18) and Nevada (0.19). Geographically, the Midwest had the highest AAMR of 0.56 in 2023 (AAPC: 8.1007*; p < 0.000001), followed by the South with an AAMR of 0.54 (AAPC: 5.4181*; p < 0.000001), then the Northeast with an AAMR of 0.41 (AAPC: 7.3614*; p < 0.000001) and the West with an AAMR of 0.41 (AAPC: 4.4606*; p < 0.000001). Conclusions: Multiple myeloma mortality among adults with coexisting mental and behavioral disorders has increased significantly in the United States over the past two decades. Pronounced disparities, with the highest burden among males, Black individuals, and residents of the Midwest. These findings highlight vulnerable populations experiencing a disproportionate mortality burden. Targeted, integrated oncologic and mental health interventions are needed to reduce disparities and improve survival outcomes.