Wilhelminen Cancer Research Institute, Vienna, Austria.
International Myeloma Foundation, Los Angeles, California, USA.
Oncologist. 2020 Sep;25(9):e1406-e1413. doi: 10.1634/theoncologist.2020-0141. Epub 2020 May 7.
The interrelation between the worldwide incidence, mortality, and survival of patients with multiple myeloma (MM) and relevant factors such as Health Care Access and Quality (HAQ) index, gross domestic product (GDP), health care expenditures, access to cancer drugs, and patient empowerment has not been addressed before.
Epidemiologic data were obtained from the International Agency for Research on Cancer. The mortality-to-incidence ratio (expressed as 1-MIR) was used as proxy for 5-year survival. Information on health expenditure was obtained from Bloomberg Health-Care Efficacy ranking, the HAQ Index was used as a measure of available health care. For patient empowerment, visits to the Web site of the International Myeloma Foundation were used as proxy. Data on GDP and population per country were assessed from the International Monetary Fund and the United Nations Population Division, respectively. Possible associations were analyzed using Spearman's rank-order correlation.
The worldwide incidence of MM is currently 160,000, and mortality is 106,000. Age-standardized myeloma incidence varies between 0.54 and 5.3 per 100,000 and correlates with 1-MIR, patient empowerment, HAQ Index, and access to cancer drugs. The 1-MIR varies between 9% and 64% and is closely related to myeloma incidence, HAQ Index, patient empowerment, access to cancer drugs, and health care expenditures.
The global incidence and outcome of MM shows significant disparities, indicating under-recognition and suboptimal treatment in many parts of the globe. Results also highlight the importance of economic resources, access to and quality of health care, and patient education for improving diagnosis and survival of patients with MM.
Multiple myeloma accounts for 10% of all hematological malignancies and has moved to the forefront of clinical interest because of the significant advances in medical treatment. Diagnosis depends on laboratory tests, imaging, and professional expertise, particularly in patients without a significant M-component. The present data show a substantial worldwide variation in incidence and mortality, that is mainly due (apart from variations due to ethnicity and lifestyle) to disparities in access to and quality of health care, a parameter strongly related to the economic development of individual countries. Improvement of quality of care and, consequently, in outcome is associated with patient empowerment.
多发性骨髓瘤（MM）患者的全球发病率、死亡率和生存率之间的相互关系，以及医疗保健可及性和质量（HAQ）指数、国内生产总值（GDP）、医疗保健支出、癌症药物可及性和患者赋权等相关因素之间的相互关系尚未得到解决。
流行病学数据来自国际癌症研究机构。死亡率与发病率的比值（表示为 1-MIR）被用作 5 年生存率的替代指标。卫生支出信息来自彭博社卫生保健疗效排名，HAQ 指数用作可获得的卫生保健措施的衡量标准。患者赋权使用国际骨髓瘤基金会网站访问量作为代理。每个国家的 GDP 和人口数据分别来自国际货币基金组织和联合国人口司评估。使用 Spearman 秩相关分析可能存在的关联。
目前全球 MM 的发病率为 16 万，死亡率为 10.6 万。年龄标准化的骨髓瘤发病率在每 10 万人 0.54 至 5.3 之间变化，与 1-MIR、患者赋权、HAQ 指数和癌症药物可及性相关。1-MIR 变化范围为 9%至 64%，与骨髓瘤发病率、HAQ 指数、患者赋权、癌症药物可及性和医疗保健支出密切相关。
全球多发性骨髓瘤的发病和结果存在显著差异，表明在全球许多地区对其认识不足且治疗效果不佳。结果还强调了经济资源、医疗保健的可及性和质量以及患者教育对改善 MM 患者的诊断和生存的重要性。
多发性骨髓瘤占所有血液系统恶性肿瘤的 10%，由于医学治疗的重大进展，已成为临床关注的焦点。诊断取决于实验室检查、影像学和专业知识，特别是在没有显著 M 成分的患者中。目前的数据显示，全球发病率和死亡率存在很大差异，这主要归因于（除了种族和生活方式的差异外）医疗保健的可及性和质量方面的差异，这一参数与个别国家的经济发展密切相关。护理质量的提高，进而改善结果，与患者赋权有关。
