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We investigated the impact of income and education on treatment and survival in a country with publicly funded healthcare. We analysed data from the Swedish Myeloma Registry (2008\u20132021) linked to national registers. Cox models assessed survival, adjusting for demographics and comorbidities. Treatment patterns were compared using cumulative incidence functions. Among 8,672 patients, higher education and income correlated with prolonged survival. Adjusted hazard ratios (HRs) for low income were 1.4 (95% CI 1.3\u20131.5) and for low education were 1.3 (95% CI 1.2\u20131.4). Higher income patients were more likely to receive lenalidomide (HR 1.5, 95% CI 1.3\u20131.6) and pomalidomide (HR 1.7, 95% CI 1.4-2.0), and less likely to receive melphalan tablets (HR 0.8, 95% CI 0.7\u20130.9). Low-income patients were less likely to undergo stem cell transplant (HR 0.8, 95% CI 0.7\u20130.9). Immigrant status or biological sex did not influence outcomes. Even in a tax-funded system, socioeconomic disparities impact myeloma survival and treatment. Lower socioeconomic status correlates with inferior outcome and more conservative treatment. Attitudinal biases may contribute to these disparities. Better treatment for the less privileged patients could significantly improve myeloma survival, advocating for efforts to overcome the influence of socioeconomic status.<\/jats:p>","DOI":"10.1007\/s00277-025-06214-3","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T01:04:35Z","timestamp":1737680675000},"page":"565-572","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Income and education affect prognosis and treatment in symptomatic myeloma"],"prefix":"10.1007","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1549-8695","authenticated-orcid":false,"given":"Gunnar","family":"Larfors","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Carlson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Day","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4756-6805","authenticated-orcid":false,"given":"Sigrun","family":"Einarsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-7265","authenticated-orcid":false,"given":"Gunnar","family":"Juliusson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshtaak","family":"Karma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Knut-Bojanowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2353-573X","authenticated-orcid":false,"given":"Ingiger\u00f0ur S\u00f3lveig","family":"Sverrisd\u00f3ttir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4115-8010","authenticated-orcid":false,"given":"Ingemar","family":"Turesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Villegas-Scivetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3297-6019","authenticated-orcid":false,"given":"Cecilie Hveding","family":"Blimark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"issue":"2","key":"6214_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1111\/ejh.13707","volume":"108","author":"CH Blimark","year":"2022","unstructured":"Blimark CH, Vangsted AJ, Klausen TW, Gregersen H, Szabo AG, Hermansen E, W\u00e5linder G, Knut-Bojanowska D, Zang C, Turesson I (2022) Outcome data from >\u200910 000 multiple myeloma patients in the Danish and Swedish national registries. 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Individual informed consent was waived by the Ethical Review Authority, as the study was based on data from mandatory national registries. All data were anonymised before analyses.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}