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Comparative Study
. 2010 Dec 16;116(25):5501-6.
doi: 10.1182/blood-2010-07-298760. Epub 2010 Sep 7.

Racial disparities in incidence and outcome in multiple myeloma: a population-based study

Affiliations
Comparative Study

Racial disparities in incidence and outcome in multiple myeloma: a population-based study

Adam J Waxman et al. Blood. .

Abstract

Multiple myeloma (MM) is the most common hematologic malignancy in blacks. Some prior studies suggest inferior survival in blacks; others suggest similar survival. Using the original 9 Surveillance, Epidemiology, and End Results registries, we conducted a large-scale population-based study including 5798 black and 28 939 white MM patients diagnosed 1973-2005, followed through 2006. Age-adjusted incidence rates, disease-specific survival, and relative survival rates were calculated by race, age, and time period of diagnosis. Mean age at diagnosis was 65.8 and 69.8 years for blacks and whites, respectively (P < .001). Incidence among blacks was m twice that among whites; this disparity was greater among patients < 50 years (P = .002). Over the entire study period, disease-specific and relative survival rates were higher in blacks than whites (P < .001). For whites, 5-year relative survival rates increased significantly 1973-1993 to 1994-1998 (26.3% to 30.8%; P < .001) and 1994-1998 to 1999-2005 (30.8% to 35.0%; P = .004). Survival improvements among blacks were smaller and nonsignificant (1973-1993 to 1999-2005: 31.0% to 34.1%; P = .07). We found (1) a younger age of onset among blacks; (2) better survival in blacks 1973-2005; and (3) significant survival improvement among whites over time, with smaller, nonsignificant change seen among blacks, possibly due to unequal access to and/or disparate responsiveness to novel therapies.

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Figures

Figure 1
Figure 1
Advances in the diagnosis and treatment of MM.
Figure 2
Figure 2
Incidence patterns of MM by race and age, 1973-2005 (SEER-9).
Figure 3
Figure 3
Disease-specific survival 1973-2005 (SEER-9), by race and age group.
Figure 4
Figure 4
Five-year RSRs by race and age group (SEER-9). *P < .05; **P < .01; ***P < .001; and –, P ≥ .05.
Figure 5
Figure 5
Age-specific 5-year RSRs before and after 1994 (novel therapies), by race.

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