A recent study provides clarity on age-, gender-, and race-associated disparities in multiple myeloma incidence. The core finding is that differences largely stem from a preceding condition more common in specific groups.
- Multiple myeloma often develops following a premalignant, asymptomatic condition called monoclonal gammopathy of undetermined significance.
- Multiple myeloma shows varying incidence rates among different genders and racial groups.
- This study focuses on understanding whether disparities arise from the incidence of monoclonal gammopathy of undetermined significance or the speed of its progression to multiple myeloma.
- Findings suggest screening high-risk groups for monoclonal gammopathy of undetermined significance could reduce multiple myeloma disparities.
Multiple myeloma (MM), a malignancy of plasma cells, resulted in an estimated 34,920 diagnoses and 12,410 deaths in the U.S. in 2021. Although consistently preceded by monoclonal gammopathy of undetermined significance (MGUS), a premalignant and asymptomatic condition, MM disparities by gender and race/ethnicity remain puzzling. There’s a notably higher burden among men and non-Hispanic Black individuals. The key question is whether this difference is due to an increased MGUS incidence, accelerated progression of MGUS to MM, or both.
Mathematical Model Overcomes Data Challenges
Prior studies that have attempted to understand the racial and ethnic disparities in MM incidence have been limited by the asymptomatic nature of MGUS. This study, published in Nature Communications, addressed this issue by designing a compartmental model of the natural history of MM to pinpoint the influences of age, gender, and race on the observed disparities in MM incidence using data from the National Health and Nutritional Examination Survey (NHANES) and the Surveillance, Epidemiology, and End Results (SEER) program.
Key Revelations From the Data Analysis
The analysis found that the disparities in MM incidence are mainly due to a higher MGUS incidence among healthy men and non-Hispanic Black populations. No significant disparities were observed in MGUS to MM progression rates. This suggests that focusing on detecting MGUS in these higher-risk groups might be key to addressing the disparities.
What This Means for Healthcare Providers
By understanding that MGUS is more prevalent in certain demographics, healthcare providers can prioritize early screenings in these groups. This proactive approach can lead to earlier diagnoses, more timely interventions, and improved patient outcomes in those at higher risk of MM.
Huber, J. H., Ji, M., Shih, Y., Wang, M., Colditz, G. A., & Chang, S. (2023). Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study. Nature Communications, 14(1). https://doi.org/10.1038/s41467-023-41223-8