Blood cancers in indigenous populations: A global systematic review of incidence, mortality, and survival (1954–2024)

The current evidence of global disparities in blood cancer incidence, mortality, and survival among Indigenous peoples are limited and fragmented. This systematic review aims to synthesize the epidemiological outcomes of blood cancer in Indigenous peoples to provide a comprehensive global perspective. Following PRISMA guidelines, this review included original papers reporting the incidence, mortality, or survival of leukaemias, lymphomas, and myelomas among Indigenous populations. CINAHL, PubMed, PsycINFO, and Embase databases were searched from inception to January 2025. Descriptive analyses on the study outcomes was conducted and the quality of the included papers were critically appraised using the Mixed Methods Appraisal Tool (MMAT). We included 126 articles spanning 16 countries, with 47% of reports published in the last 15 years and 90% originating from the US, Canada, New Zealand, and Australia, highlighting the scarcity of data from Indigenous peoples outside high-income nations. While substantial heterogeneity limited direct comparisons of outcomes, analysis revealed that Indigenous peoples with blood cancer consistently experience poorer survival. Quality appraisal using the MMAT rated 83% of studies as high or good quality. This systematic review heavily concentrated on high-income countries, with very little evidence available from other regions. Most studies were rated high or good quality, reinforcing the reliability of these findings on poorer survival outcomes for Indigenous peoples compared to non-Indigenous groups diagnosed with a blood cancer. This underscores the urgent need for improved global data collection, greater Indigenous leadership in research, and targeted interventions to address these persistent survival disparities.