Racial Disparities in Myeloma Incidence, Mortality, and Survival Rates Among Adolescents and Young Adults in the United States: An Analysis of the SEER Database

Introduction/Background/Significance: Background: Adolescent and young adult (AYA) patients between the ages of 15 and 39 form a distinct and under-researched group in oncology. Myeloma is rare within this age category, and the racial and ethnic disparities related to incidence, mortality, and survival outcomes are still not well defined.

Materials and Methods/Case Presentation/Objective: Methods: We conducted a retrospective cohort analysis using the SEER Research Plus database from 2000 to 2021 (22 registries). Patients aged 15–39 years who were diagnosed with myeloma were included. Age-adjusted incidence and mortality rates were calculated using SEER*Stat version 8.4.4. Kaplan-Meier survival estimates, and Cox proportional hazards modeling were performed using R version 4.3.2 to evaluate survival outcomes by race/ethnicity.

Results/Description/Main Outcome Measures: Results:

A total of 1,740 AYA myeloma cases were identified; 59% were male. The racial/ethnic distribution included 41.3% White, 25.5% Black, 24.8% Hispanic, 7.2% Asian/Pacific Islander (API), and 0.1% American Indian/Alaska Native. The overall incidence rate increased from 0.3 to 0.4 per 100,000 from 2000 to 2021, with mortality rising from 0.02 to 0.04 per 100,000. Notably, females showed a declining mortality trend (0.02 to 0.01 per 100,000). Black AYA patients had the highest incidence and mortality in 2021 (0.8 and 0.08 per 100,000, respectively). While Kaplan-Meier and multivariable Cox analyses suggested a trend toward worse survival in non-White groups, these findings did not reach statistical significance. API patients demonstrated a trend toward better survival compared to White patients, although this also lacked statistical significance.

Conclusions: The incidence and mortality of AYA myeloma have increased over the past two decades. Black AYA patients experience a disproportionate burden of disease, with the highest incidence and mortality rates. Although statistical significance was not observed, trends suggest potential racial disparities in survival outcomes. Further research with larger sample sizes is warranted to confirm these findings and guide equitable care strategies.