(PA-418) Mortality and Trends of Multiple Myeloma in Brazil: A 27-Year Analysis.

Introduction:  Multiple myeloma (MM) is a plasma cell malignancy primarily affecting older adults. Global disparities in diagnosis, access to care, and mortality are well documented, particularly in low- and middle-income countries. In Brazil, socioeconomic and geographic heterogeneity may influence outcomes. Understanding long-term trends and demographic patterns is critical for developing equitable public health strategies.

Methods:   An ecological study was conducted using mortality data from the Mortality Information System (SIM) and population estimates from Brazilian Institute of Geography and Statistics (IBGE). Mortality rates due to MM aged ≥40 years between 1997 to 2023. Analyses included stratification by sex, age, race, region, and occupation. Trends were assessed by Joinpoint regression and age-period-cohort (APC) models were used to explore the effects.

Results:   A total of 63,105 deaths were recorded in Brazil. Men accounted for 51.2% of deaths. Age-adjusted mortality increased from 0.40 per 100,000 in 1997 to 0.85 in 2023. Race analysis showed that white individuals accounted for 60% of deaths, followed by mixed-race (26%) and Black individuals (7.8%). Workers in and construction (10%) had elevated mortality followed by agriculturists and workers in livestock, forestry, and fishing (8.2%). For the cohort, there is an increase in relative risk in males (1990) and a recent rise among females (male RR 1.45; female RR 1.53). There was a decline trends for males [(-1.87%); CI: -2.52; -1.19)] and less for females [(-0.43%); CI: -0.65; -0.21)], with sharper declines in ages 40–49 (men: -2.22%; women: -2.83%).

Conclusions:   Mortality from MM in Brazil rose overall from 1997 to 2023, more in males and less in females. Elevated mortality was found among construction workers and white race. These findings underscore the urgent need for targeted policies addressing occupational exposures, regional inequalities, and timely access to diagnosis and treatment.