Trends in myeloma incidence and mortality by racial/ethnic group observed from 2003 to 2016

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Incidence rates of multiple myeloma increased in non-Hispanic white males, remained stable in males and females of all racial and ethnic groups, and decreased in American Indian/Alaska Native, non-Hispanic white patients and non-Hispanic black men and Hispanic women from 2003 to 2016, although incidence rates remained highest among blacks and Hispanics.

Over this period, the researchers noted that the overall incidence rates were 0.45 for solitary plasmacytoma, 0.09 for extramedullary plasmacytoma, and 8.47 for multiple myeloma per 100,000 adults. Additionally, the incidence of multiple myeloma from 2003 to 2016 increased in non-Hispanic white patients (mean annual percent change [AAPC], 1.78%) and non-Hispanic black patients (AAPC, 2.98%) aged 20-49 years. Incidence rates also increased for non-Hispanic white and non-Hispanic black people aged 50 and 59, respectively (AAPC, 1.17% and 1.24%). Overall, the 2 groups had an increase of 0.91% and 0.96%, respectively.

“The results of our study are consistent with other studies showing that the incidence of multiple myeloma is higher in non-Hispanic black patients and Hispanic patients than in non-Hispanic white patients. We also found that the rates of “Incidence of multiple myeloma was increasing in ages 20 to 69, but it is still primarily a disease in older people. Understanding the role of these characteristics may inform understanding of future myeloma rates,” the authors wrote. .

Investigators used population-based data from US Cancer Statistics that combined datasets from the Centers for Disease Control and Prevention’s National Cancer Registry Program. and the Surveillance, Epidemiology and End Results program. Selected cases included patients with solitary and extramedullary plasmacytoma and multiple myeloma, the majority of which were confirmed by microscopy (87.54%), several others were confirmed by laboratory tests (2.24%), one x-ray (1.61%) or by unknown means (6.55%).

Additional results indicated that incidence rates were higher in men than in women for several disease types, including solitary plasmacytoma (RR, 1.92; 95% CI, 1.85-1, 98), extramedullary plasmacytoma (IRR, 1.99; 95% CI, 1.86-2.12), and multiple myeloma (IRR, 1.50; 95% CI, 1.49-1.52) .

In terms of age-specific incidence, rates were highest in people 80 years or older compared to other age groups in all disease types, including solitary plasmacytoma (IR, 1.51 per 100 000 people), extramedullary plasmacytoma (IR, 0.42) and multiple myeloma. (RI, 38.32). Disease incidence was lowest in people aged 20-49, with rates of 0.12 for solitary plasmacytoma, 0.04 for extramedullary plasmacytoma, and 1.20 for multiple myeloma per 100,000 people.

When assessing incidence by race, investigators reported that non-Hispanic black patients had the highest incidence among all groups, including 0.67 per 100,000 people for solitary plasmacytoma, 0.16 for extramedullary plasmacytoma and 17.43 for multiple myeloma. Individuals from Asia and the Pacific Islands had the lowest incidence rates of solitary plasmacytoma (IR, 0.18 per 100,000) and multiple myeloma (IR, 4.91), and the incidence of plasmacytoma extramedullary was lowest in non-Hispanic white individuals (IR, 0.12 per 100,000).

Also, the incidence of solitary plasmacytoma was somewhat higher in people residing in a non-metropolitan area compared to a metropolitan area.

Over the period, myeloma-related mortality in adult patients was 4.47 per 100,000 people, with men having a statistically higher rate (MR, 5.97) than women (MR, 3.86; MRR, 1.55; 95% CI, 1.53-1.56) . Additionally, in terms of age-specific deaths, those who were aged 50-59 (RR, 10.62; 95% CI, 10.28-10.98), 60-69 (RR, 32. 94; 95% CI, 31.94-33.99), 70-79 years (RR, 79.29; 95% CI, 76.92-81.76) and 80 years or older (RR, 131, 24; 95% CI, 127.31-135.31) had the highest mortality rate compared to younger patients aged 20-49 years (0.26 per 100,000).

Mortality was highest in non-Hispanic black patients (9.12 per 100,000) compared to non-Hispanic white patients (2.05; 95% CI, 2.03-2.08). Mortality rates were particularly low among American Indian and Alaska Native patients (4.03 per 100,000; RR, 0.91; 95% CI, 0.84-0.98), Asian and Islander patients Pacific patients (2.3; RR, 0.52; 95% CI, 0.50-0.54), and Hispanic patients (3.97; RR, 0.89; 95% CI, 0.87 -0.91) compared to non-Hispanic white patients (MR, 4.44).

The investigators noted that the incidence of multiple myeloma increased by 0.81% in male patients per year, as well as 0.92% in white men per year. The incidence also increased in American Indian and Alaska Native patients by 2.19% per year. No other statistically significant changes were noted among men of other racial or ethnic groups. Although the incidence of multiple myeloma increased by 0.75% in women each year, no significant changes were noted in women of any racial or ethnic group.

Reference

Ellington TD, Henley SJ, Wilson RJ, et al. Trends in incidence of solitary plasmacytoma, extramedullary plasmacytoma, and plasma cell myeloma and myeloma mortality by racial‐ethnic group, United States 2003‐2016. CancerMed. 2021;10(1):386-395. doi:10.1002/cam4.3444

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