Skip to main content
IMS Events Main banner

    Treatment of Newly Diagnosed Myeloma (excluding t-cell redirection therapy)

    Category: Treatment of Newly Diagnosed Myeloma (excluding t-cell redirection therapy)

    Temporal Trends in Multiple Myeloma Mortality in Ecuador, 2010 – 2022: A Nationwide Joinpoint Analysis

    (PA-392) Temporal Trends in Multiple Myeloma Mortality in Ecuador, 2010 – 2022: A Nationwide Joinpoint Analysis

    Wednesday, September 17, 2025

    Introduction:      









    There is a lack of detailed research on multiple myeloma (MM) mortality trends specific to Ecuador, a country with its own demographic and healthcare factors that could influence outcomes. Therefore, we conducted the first nationwide assessment of MM mortality in Ecuador. Using 2010-2022 death-certificate micro-data from the National Institute of Statistics and Census (INEC), computed annual crude (CMR) and age-standardised mortality rates (ASMR), and modelled temporal changes with joinpoint regression. 


















    Methods:   This observational, cross-sectional study quantifies crude mortality attributed to multiple myeloma (MM) in Ecuador from 2010-2022 and characterises its temporal trajectory. Mortality micro-data were drawn from the publicly available death-certificate files issued annually by the National Institute of Statistics and Census (INEC) and downloadable in SPSS format from Ecuador en Cifras (https://www.ecuadorencifras.gob.ec/camas-y-egresos-hospitalarios/). Records coded C90.0 (ICD-10) were aggregated by calendar year.
    To compute the crude mortality rate, we applied the following equation:
    Crude mortality rate = (Total number of deaths in a calendar year by MM / Estimated mid-year population for that year) * 106

    The upper and lower limits of the 95% confidence intervals were calculated using the following formulas:
    Upper Limit = (1000 / n) [d + (1.96 × √d)]
    Lower Limit = (1000 / n) [d - (1.96 × √d)]
    Temporal patterns were modelled with Joinpoint® regression (≤ 3 joinpoints; permutation test α = 0.05), yielding segment-specific annual percentage change (APC). This approach pinpoints statistically significant inflexion points, revealing periods of acceleration or deceleration in MM mortality across the 2010-2022 interval.




    Results:   A total of 1,642 MM deaths were recorded (57 % male); median age 69 years (IQR 17). National CMR varied from 14.99 / 1,000,000 in 2010 to 16.61 / 1,000,000 in 2022, reaching a nadir in 2012 (14.10) and a peak in 2019 (23.55). Joinpoint analysis revealed three segments: 2010-2015 (APC +1.22 %), 2017-2018 (APC +10.84 %), and 2020-2022 (APC –11.72 %). Male mortality peaked at 25.65 / 1,000,000 in 2017 (2010-2019 APC +4.41 %, 2021-2022 APC –14.14 %), whereas female mortality peaked at 21.45 / 1,000,000 in 2019 (2010-2018 APC +3.68 %, 2020-2022 APC –10.24 %). Mortality rates rose step-wise with age, the highest burden occurring in individuals ≥ 80 years.


    Conclusions:   

    MM mortality in Ecuador followed a rise–spike–decline pattern, peaking just before the national adoption of bortezomib and expansion of specialist haematology services, then falling sharply during 2020-2022. Sustained access to novel agents, earlier diagnosis, and strengthened cancer-registry infrastructure are essential to maintain this downward trajectory.