Global burden of multiple myeloma(1990-2021) and projections up to 2035: a methodical analysis leveraging the global burden of disease 2021 study and Mendelian randomization

Multiple myeloma (MM), being the second-most frequently occurring hematologic malignancy, is comprehensively assessed for its global disease burden and risk factors using the Global Burden of Disease (GBD) database and Mendelian Randomization (MR).

This research utilized data from the GBD 2021 database to extensively investigate age-standardized incidence rates, mortality rates, as well as Disability - Adjusted Life Years (DALYs) linked to MM. We evaluated the impact of various geographical areas, age brackets, genders, risk factors, and Socio-Demographic Index (SDI) on the disease burden of MM. Additionally, Joinpoint regression was employed by us to analyze the temporal trends of this burden. We integrated GBD data with a two-sample MR method for causal inference to further investigate causal relationships between risk factors and MM. Finally, we applied Bayesian-Age-Period-Cohort (BAPC) models to predict future trends in MM's disease burden by using GBD data as a foundation.

In 2021, the global incidence of MM was 148,755 cases, with 116,359 deaths and a total of 2,595,595 DALYs. The global age-standardized rates of MM were 1.74 (incidence), 1.37 (mortality), and 30.00 (DALYs) per 100,000 population, with higher rates observed in high-income areas. From 1990 to 2021, the annual average percentage change (AAPC) in global MM incidence was 0.54%, mortality was 0.20%, and DALYs was 0.18%. The MM burden associated with high BMI was concentrated within high-income areas such as those in Australasia and North America, while South Asia and Southeast Asia exhibited the lowest proportional burden. To further validate the causal link between BMI and MM, we conducted a two-sample MR.

Over 30 years, the worldwide burden of MM has shown a significant rise. High-income countries show slowing trends due to improved healthcare, while low/middle-income regions face rising burdens from underdiagnosis and limited access. We demonstrate a positive association between elevated BMI and increased MM risk by using MR, underscoring the imperative for obesity control in high-income nations to alleviate the MM disease burden. This study offers a basis for optimizing global health policies, improving early diagnosis, and resource allocation against the ongoing threat of MM.