Temporal Trends and Demographic Disparities in Multiple Myeloma Mortality in the United States, 1999-2025: A CDC WONDER Analysis
Multiple myeloma remains a major hematologic malignancy associated with substantial mortality despite advances in diagnosis and treatment. We evaluated long-term trends and demographic disparities in multiple myeloma-related mortality in the United States.
Materials and Methods/Case Presentation/Objective:
We conducted a population-based trend analysis using the CDC WONDER Multiple Cause of Death database (1999-2025). Deaths with ICD-10 code C90 were identified. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Joinpoint regression was used to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). Mortality trends were stratified by sex, age group, race/ethnicity, U.S. Census region, and urbanization.
Results/Description/Main Outcome Measure(s): A total of 376,448 multiple myeloma-related deaths were identified. The overall AAMR decreased from 7.07 per 100,000 in 1999 to 5.22 in 2025, corresponding to an overall AAPC of −1.33% (95% CI, −1.55 to −1.16; P< 0.001). Mortality declined significantly during 1999-2008 (APC −1.76%), plateaued during 2008-2021, and declined more rapidly during 2021-2025 (APC −3.43%; P< 0.001). Similar declining trends were observed among females (AAPC −1.62%) and males (AAPC −1.16%) (both P< 0.001). By age, mortality decreased significantly among adults aged 35-44 years (AAPC −2.69%), 45-54 years (−2.60%), 55-64 years (−2.93%), 65-74 years (−2.35%), and 75-84 years (−0.58%), whereas individuals aged ≥85 years experienced a significant increase (AAPC 0.68%; P< 0.001). Mortality also declined across racial and ethnic groups, including American Indian/Alaska Natives (AAPC −1.83%), Asian/Pacific Islanders (−1.18%), Black individuals (−0.93%), Hispanics (−0.98%), and White individuals (−1.29%) (all P< 0.001). Regionally, all U.S. Census regions demonstrated significant declines, with the largest reduction observed in the Northeast (AAPC −1.74%). Likewise, mortality decreased significantly across all levels of urbanization.
Conclusion(s).: Multiple myeloma mortality declined steadily in the United States over the past 27 years, likely reflecting advances in diagnosis and treatment. However, the rising mortality among adults aged ≥85 years highlights an important unmet need and supports continued efforts to improve outcomes and reduce disparities in this high-risk population.
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