Unveiling sex-based geographical disparities in myelodysplastic syndrome mortality trends in Spain (1999-2022)

Reyes María Martín-Rojas; Lucía Cayuela; Francisco Martín-Domínguez; Aurelio Cayuela

doi:10.1007/s12094-024-03503-7

Unveiling sex-based geographical disparities in myelodysplastic syndrome mortality trends in Spain (1999-2022)

Clin Transl Oncol. 2024 May 19. doi: 10.1007/s12094-024-03503-7. Online ahead of print.

Authors

Reyes María Martín-Rojas¹, Lucía Cayuela², Francisco Martín-Domínguez³, Aurelio Cayuela⁴

Affiliations

¹ Service d'Hématologie Clinique Et de Thérapie Cellulaire, Hôpital Saint Antoine, Paris, France. reyes.martinrojas@gmail.com.
² Department of Internal Medicine, Hospital Severo Ochoa, Leganés, Spain.
³ Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CISC), Seville, Spain.
⁴ Unit of Public Health, Prevention and Health Promotion, South Seville Health Management Area, Seville, Spain.

PMID: 38762824
DOI: 10.1007/s12094-024-03503-7

Abstract

Aim: To comprehensively analyze trends in myelodysplastic neoplasm (MDS) mortality across Spain (1999-2022), examining sex and regional differences.

Methods: We analyzed nationwide death records and population data, calculating age-standardized mortality rates (ASMRs) and standardized mortality ratios (SMRs) stratified by sex and Autonomous Community (AC). Joinpoint regression identified significant shifts in trends.

Results: Across Spain, MDS mortality risk varied among men, with rates ranging from 1.08 to 4.38 per 100,000 across regions, while women's rates ranged from 1.23 to 2.02. Five regions had higher risks than the national average, while six had lower risks. Joinpoint analysis revealed three periods nationally: a decline until 2008, and an increase until 2017, followed by a significant decrease. Despite the overall stable national trend (-0.5% annual change), significant regional variations emerged. Andalusia stood out with a worrying increase in MDS mortality, while Aragon and Murcia demonstrated promising declines. Extremadura displayed a unique trajectory with an initial rise followed by stabilization, while Galicia exhibited a contrasting trend with an initial decline and subsequent increase. Notably, men consistently faced a higher risk of MDS mortality compared to women, with significant disparities across regions. Extremadura, in particular, showed a marked difference in risk between genders.

Conclusion: MDS mortality trends in Spain are complex, and influenced by gender, region, and time. Further research is needed to understand regional disparities, recent national decline, and higher risk in specific demographics. Tailored interventions based on local factors and targeted research are crucial to address these complexities and improve patient outcomes.

Keywords: Gender; Mortality; Myelodysplastic neoplasms; Public health interventions; Region; Spain; Time trends.