Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States

Abstract

Prior improvements in multiple myeloma (MM) survival were not fully observed in racial and ethnic minorities and older individuals. We hypothesized that improvements in MM management in recent years have reduced these disparities. We used the Surveillance, Epidemiology, and End Results registries to calculate the incidence and relative survival rates (RSRs) of MM in the United States for patients diagnosed from 1993 to 1997 (prethalidomide), 1998 to 2002 (introduction of thalidomide), 2003 to 2007 (bortezomib and lenalidomide), and 2008 to 2012 (upfront bortezomib and lenalidomide, early availability of carfilzomib and pomalidomide). MM incidence increased significantly among non-Hispanic whites (NHWs) and non-Hispanic black (NHB) men, but not among NHB women and Hispanics. Improvement in 5-year RSRs (1993-1997 vs 2008-2012) was seen among patients of all age and race/ethnicity groups. Ten-year RSRs (1993-1997 vs 2003-2007) improved for patients <65 years of age (19.6%-35%; P < .001), but not for patients ≥75 years of age (7.8%-9.3%; P = .3). Among patients 65 to 74 years of age, 10-year RSRs improved for NHWs (11.3% vs 20.5%; P < .001) and Hispanics (10.6% vs 20.2%; P = .02), but not for NHBs (12.6% vs 19.5%; P = .06.). These findings confirm consistent improvement in survival for MM patients and point to the challenge of further extending these improvements to older and minority patients.

Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

Graphical abstract

Figure 1.

Changes in RSRs of patients diagnosed with MM in the United States grouped by sex, age, or race/ethnicity. Changes in RSR for all individuals (A), males (B), females (C), individuals diagnosed at age <65 years (D), individuals diagnosed at age 65 to 74 years (E), individuals diagnosed at age ≥75 years (F), NHW (G), NHB (H), and Hispanics (I) irrespective of age.

Figure 2.

Changes in 5-year and 10-year relative survival of patients diagnosed with MM according to sex and race/ethnicity. Changes in 5-year and 10-year RSR for NHW (A), NHB (B), and Hispanics (C) according to sex.

Figure 3.

Changes in 5-year and 10-year relative survival of patients diagnosed with MM according to age and race/ethnicity. Changes in 5-year and 10-year RSR for patients diagnosed at age <65 years (A), 65 to 74 years (B), and ≥75 years (C) according to race/ethnicity.