Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study

Abstract

Multiple myeloma (MM) is a hematological malignancy that is consistently preceded by an asymptomatic condition, monoclonal gammopathy of undetermined significance (MGUS). Disparities by age, gender, and race/ethnicity in both MGUS and MM are well-established. However, it remains unclear whether these disparities can be explained by increased incidence of MGUS and/or accelerated progression from MGUS to MM. Here, we fit a mathematical model to nationally representative data from the United States and showed that the difference in MM incidence can be explained by an increased incidence of MGUS among male and non-Hispanic Black populations. We did not find evidence showing differences in the rate of progression from MGUS to MM by either gender or race/ethnicity. Our results suggest that screening for MGUS among high-risk groups (e.g., non-Hispanic Black men) may hold promise as a strategy to reduce the burden and MM health disparities.

Multiple myeloma incidence and mortality trends in the United States, 1999–2020

“…Our data aligns with existing literature that non-Hispanic Black Americans exhibit the highest MM incidence and mortality rates 23 – 25 . These disproportionately higher rates observed among non-Hispanic Black Americans highlight the imperative for further research examining the multifaceted etiology of MM morbidity and mortality, encompassing both genetic predispositions and socio-environmental determinants to inform future targeted intervention strategies.…”

“…Broader socioeconomic and structural inequalities also contribute to SIRE disparities in MM incidence and mortality. Structural barriers, including lower median incomes and higher unemployment rates among non-Hispanic Black populations, limit access to quality healthcare and novel treatments, which may contribute to variations in survival outcomes among MM patients 7 , 8 , 24 , 25 . Socioeconomic status may influence other upstream social factors such as education, income, and access to health insurance, all crucial for managing MM, particularly given the substantial financial burden and distress associated with its management 24 , 25 .…”

“…These findings echo trends observed in prior studies, which consistently show that men are approximately 1.5-fold more likely to develop MM 50 . Independent of factors like age and socioeconomic status, male gender remains a risk factor for MGUS and MM 25 . Gender disparities in MM can be further explained by the increased incidence of MGUS among healthy male populations.…”

“…Gender disparities in MM can be further explained by the increased incidence of MGUS among healthy male populations. The higher incidence of MM in males may also imply that sex plays a role in MM pathogenesis 25 , although the underlying mechanisms remain poorly understood, warranting further exploration. One plausible explanation for the higher risk among men is the greater prevalence of hyperdiploidy, characterized by the gain of multiple odd-numbered chromosomes, which is more common in males 51 .…”

N6-methyladenosine-modified circ_0000337 sustains bortezomib resistance in multiple myeloma by regulating DNA repair

“…Multiple myeloma (MM) is a malignant tumor with abnormal plasma cell proliferation (Huber et al, 2023). According to the American Cancer Society estimates, the number of new cancer cases is 35,780, and the deaths are 12,540 in MM (Siegel et al, 2024).…”