My local oncologist has been seeing more myeloma patients over the last few years, so just wondering if there is data out there regarding this issue.
Thanks, Stann
Forums
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Stann - Name: Stann
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 9/11/09
- Age at diagnosis: 46
Re: Are multiple myeloma cases on the rise?
Hi Stann,
Thanks for your question.
The simple answer to your question is: Yes, the number of new myeloma cases (in the U.S.) has been rising steadily every year. There were about 24,000 new cases of myeloma in the U.S. last year. Just a few years ago, the new cases in a single year was less than 20,00.
But this increase shouldn't necessarily surprise us, for two reasons.
First, the U.S. population is growing in general.
Second, myeloma is a disease that strikes older people, and the U.S. population has been becoming older over the past few decades as the baby boomer generation ages.
The question we think you're really asking is: Separate from the two factors we just mentioned (population growth, and aging of the population), is the number of myeloma cases in the U.S. increasing?
To answer that question for any disease, not just myeloma, researchers calculate a number called the "age-adjusted incidence" of the disease. It is just the number of new cases of the disease per 100,000 members of the population, with an adjustment in the calculation designed to factor out changes in how old the population is.
If a disease that strikes predominantly older people is not becoming any more common over time, then a carefully calculated "age-adjusted incidence" of the disease will not change regardless of the size of the population and whether or not the population consists primarily of older, or younger, people.
Here is a graph of the age-adjusted incidence of multiple myeloma in the U.S. over the past 40 years. As you'll see, the incidence has increased over time.
Age-Adjusted Incidence of Myeloma, and Number of Deaths from Myeloma, in the U.S.
As you can see, the incidence has increased, going from about 5 cases per 100,000 people in the U.S. in 1975 to 6.5 in 2011. But the increase has primarily been slow, although there has been a noticeable uptick in the most recent years.
In case you are interested, we're also including the numbers for the chart in the table below.
Hope this helps a bit.
Age-Adjusted Incidence of Myeloma in the U.S.
Year Incidence
1975 4.9
1976 5.0
1977 5.1
1978 4.7
1979 4.9
1980 4.8
1981 5.0
1982 5.3
1983 5.3
1984 5.4
1985 5.2
1986 5.3
1987 5.9
1988 5.3
1989 5.4
1990 5.7
1991 6.0
1992 6.0
1993 5.6
1994 5.7
1995 5.7
1996 5.8
1997 6.1
1998 6.0
1999 5.6
2000 6.1
2001 5.9
2002 6.0
2003 5.9
2004 5.9
2005 6.2
2006 5.9
2007 6.0
2008 6.3
2009 6.4
2010 6.6
2011 6.7
Data source: U.S. National Cancer Institute, SEER database.
Thanks for your question.
The simple answer to your question is: Yes, the number of new myeloma cases (in the U.S.) has been rising steadily every year. There were about 24,000 new cases of myeloma in the U.S. last year. Just a few years ago, the new cases in a single year was less than 20,00.
But this increase shouldn't necessarily surprise us, for two reasons.
First, the U.S. population is growing in general.
Second, myeloma is a disease that strikes older people, and the U.S. population has been becoming older over the past few decades as the baby boomer generation ages.
The question we think you're really asking is: Separate from the two factors we just mentioned (population growth, and aging of the population), is the number of myeloma cases in the U.S. increasing?
To answer that question for any disease, not just myeloma, researchers calculate a number called the "age-adjusted incidence" of the disease. It is just the number of new cases of the disease per 100,000 members of the population, with an adjustment in the calculation designed to factor out changes in how old the population is.
If a disease that strikes predominantly older people is not becoming any more common over time, then a carefully calculated "age-adjusted incidence" of the disease will not change regardless of the size of the population and whether or not the population consists primarily of older, or younger, people.
Here is a graph of the age-adjusted incidence of multiple myeloma in the U.S. over the past 40 years. As you'll see, the incidence has increased over time.
Age-Adjusted Incidence of Myeloma, and Number of Deaths from Myeloma, in the U.S.
- MyelomaIncidence.jpg (30.3 KiB) Viewed 2292 times
As you can see, the incidence has increased, going from about 5 cases per 100,000 people in the U.S. in 1975 to 6.5 in 2011. But the increase has primarily been slow, although there has been a noticeable uptick in the most recent years.
In case you are interested, we're also including the numbers for the chart in the table below.
Hope this helps a bit.
Age-Adjusted Incidence of Myeloma in the U.S.
Year Incidence
1975 4.9
1976 5.0
1977 5.1
1978 4.7
1979 4.9
1980 4.8
1981 5.0
1982 5.3
1983 5.3
1984 5.4
1985 5.2
1986 5.3
1987 5.9
1988 5.3
1989 5.4
1990 5.7
1991 6.0
1992 6.0
1993 5.6
1994 5.7
1995 5.7
1996 5.8
1997 6.1
1998 6.0
1999 5.6
2000 6.1
2001 5.9
2002 6.0
2003 5.9
2004 5.9
2005 6.2
2006 5.9
2007 6.0
2008 6.3
2009 6.4
2010 6.6
2011 6.7
Data source: U.S. National Cancer Institute, SEER database.
Re: Are multiple myeloma cases on the rise?
Stann, I, too, thank you for your interesting question. I thank the Beacon staff for responding so fully and responsibly . This was good.
Re: Are multiple myeloma cases on the rise?
Stann, I just want to add this thought. Even today, there are many multiple myeloma people who do not get diagnosed until they are really far along. I imagine that many die without even being aware of their condition. So, is it possible that multiple myeloma people in 1975 really were under diagnosed and if the same awareness was applied back then, the 4.9 figure would be higher?
Re: Are multiple myeloma cases on the rise?
We've gotten some feedback from Dr. Vincent Rajkumar of the Mayo Clinic on the graph and data we posted above. He said that:
The change in the diagnostic criteria for myeloma that Dr. Rajkumar mentions in the last sentence is the broadening of the criteria that he described in his column for The Beacon last fall, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders" (Oct 26, 2014).
Dr. Rajkumar also noted that the most recent data from his colleague Dr. Robert Kyle on the long-term trends for myeloma incidence can be found in this paper:
RA Kyle et al, "Incidence of multiple myeloma in Olmsted County, Minnesota," Cancer, December 2004 (link to full text of article).
The apparent increase in age-adjusted incidence is likely secondary to increased recognition and diagnostic abilities. Decade by decade published data by Kyle show NO increase in true age-adjusted incidence if using the same criteria. We will also see a further increase in apparent cases of myeloma in the future since we have modified the diagnostic criteria for myeloma."
The change in the diagnostic criteria for myeloma that Dr. Rajkumar mentions in the last sentence is the broadening of the criteria that he described in his column for The Beacon last fall, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders" (Oct 26, 2014).
Dr. Rajkumar also noted that the most recent data from his colleague Dr. Robert Kyle on the long-term trends for myeloma incidence can be found in this paper:
RA Kyle et al, "Incidence of multiple myeloma in Olmsted County, Minnesota," Cancer, December 2004 (link to full text of article).
Re: Are multiple myeloma cases on the rise?
I hate that line "myeloma is a disease that affects older people". That is what we were told when our daughter was diagnosed at 32. From reading the Beacon, I see others that were diagnosed in their 30's and 40's. I have even heard of someone being diagnosed at 17.
Is there any data on the age at diagnosis?
No disrespect to older patients, but a myeloma diagnosis for younger people is difficult when you have to work, have young children, and deal with the full-time job of trying to stay alive and side effects.
Is there any data on the age at diagnosis?
No disrespect to older patients, but a myeloma diagnosis for younger people is difficult when you have to work, have young children, and deal with the full-time job of trying to stay alive and side effects.
Re: Are multiple myeloma cases on the rise?
Thanks for your comment, Terri. You are right that we should have qualified our earlier statement so that it said that myeloma primarily affects older people.
As you might expect, there are in fact data available on the age at which people are diagnosed with multiple myeloma. Please see the graph below for the age distribution for people diagnosed with myeloma in the U.S., which is from the same National Cancer Institute database as the myeloma incidence statistics that my colleagues and I provided in the posting earlier in this thread.
As you'll see in the graph, some 85 percent of newly diagnosed myeloma patients in the U.S. are 55 years of age or older at diagnosis, and less than 1 percent are under the age of 35.
Of course, each single diagnosis of myeloma is one diagnosis too many, and I am very sorry for the struggles you and your daughter have had as a result of her myeloma.
As you might expect, there are in fact data available on the age at which people are diagnosed with multiple myeloma. Please see the graph below for the age distribution for people diagnosed with myeloma in the U.S., which is from the same National Cancer Institute database as the myeloma incidence statistics that my colleagues and I provided in the posting earlier in this thread.
- MyelomaNewCasesByAge.jpg (56.79 KiB) Viewed 2021 times
As you'll see in the graph, some 85 percent of newly diagnosed myeloma patients in the U.S. are 55 years of age or older at diagnosis, and less than 1 percent are under the age of 35.
Of course, each single diagnosis of myeloma is one diagnosis too many, and I am very sorry for the struggles you and your daughter have had as a result of her myeloma.
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Boris Simkovich - Name: Boris Simkovich
Founder
The Myeloma Beacon
Re: Are multiple myeloma cases on the rise?
Wow. It seems like there are many of us under the age of 55. Perhaps it's demographics or the fact that many of the (with all due respect) "older" population don't use a computer...like my 80+ year old mom. Has there been a weekly poll on age at time of diagnosis?
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gardengirl - Name: gardengirl
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Nov. 2013
- Age at diagnosis: 47
Re: Are multiple myeloma cases on the rise?
Hi GardenGirl,
Thanks for your comment.
Yes, we've done a couple weekly polls on age at diagnosis among forum participants who have multiple myeloma. Here is a link to the most recent one, which was done in 2013.
There have been similar polls done for smoldering myeloma and MGUS. You can find all of them by doing a search from the forum search box on the keywords "weekly poll age."
Thanks for your comment.
Yes, we've done a couple weekly polls on age at diagnosis among forum participants who have multiple myeloma. Here is a link to the most recent one, which was done in 2013.
There have been similar polls done for smoldering myeloma and MGUS. You can find all of them by doing a search from the forum search box on the keywords "weekly poll age."
Re: Are multiple myeloma cases on the rise?
As a follow-up to the Beacon Staff postings earlier in this thread, I spoke this morning with Dr. Rajkumar about the data that are available concerning the incidence of multiple myeloma in the U.S.
He emphasized several times during our discussion that, based on the data he has seen, he does not believe there has been any significant change in how often myeloma is actually occurring in the U.S. once you control for the size of the population and the age, sex, and race of the population.
As Dr. Rajkumar mentioned in the quote from him that was posted earlier in the thread, doctors have gotten better over the last several decades in diagnosing myeloma. People who, in the past, would have been incorrectly diagnosed as having a disease other than myeloma, or would not have been diagnosed with any disease whatsoever, are now being correctly diagnosed with multiple myeloma.
This change is an important reason why national, age-adjusted incidence rates for myeloma in the U.S. seem to be going up, Dr. Rajkumar says.
Another reason is that myeloma is being diagnosed earlier today than it was 10, 15, and 20 years ago. This also can make it seem like the incidence of myeloma is increasing without any real change in how often the disease is actually occurring.
The trend to earlier diagnosis is evident, for example, when one looks at changes in the distribution of newly diagnosed myeloma patients by their stage at diagnosis. In recent years, Dr. Rajkumar said, more myeloma patients are being diagnosed when their myeloma is in its earlier stages (Stage 1, for example, versus Stage 3).
We all can think of different reasons for the trend to more accurate and earlier diagnoses of myeloma. Those reasons include improved imaging techniques, improved laboratory tests, greater awareness of the diagnostic criteria for myeloma, and greater awareness of the disease itself – brought about, in part, by more treatments being available for it.
None of this means that more work shouldn't be done to get myeloma diagnosed more accurately and earlier than it is now. That is not what Dr. Rajkumar is saying.
What he is saying, however, is that, based on the work of Dr. Kyle and what can be seen in the national datasets for the U.S., it does not appear that there has been any significant change in the risk of someone in the U.S. developing multiple myeloma once you control for the person's age, sex, and race.
If you were able to compile national statistics about the incidence of myeloma that took all those factors into control, and if the statistics accurately captured all true cases of myeloma when they occurred, Dr. Rajkumar believes the statistics would not show any substantial change in the incidence of myeloma over the last 30 years.
He emphasized several times during our discussion that, based on the data he has seen, he does not believe there has been any significant change in how often myeloma is actually occurring in the U.S. once you control for the size of the population and the age, sex, and race of the population.
As Dr. Rajkumar mentioned in the quote from him that was posted earlier in the thread, doctors have gotten better over the last several decades in diagnosing myeloma. People who, in the past, would have been incorrectly diagnosed as having a disease other than myeloma, or would not have been diagnosed with any disease whatsoever, are now being correctly diagnosed with multiple myeloma.
This change is an important reason why national, age-adjusted incidence rates for myeloma in the U.S. seem to be going up, Dr. Rajkumar says.
Another reason is that myeloma is being diagnosed earlier today than it was 10, 15, and 20 years ago. This also can make it seem like the incidence of myeloma is increasing without any real change in how often the disease is actually occurring.
The trend to earlier diagnosis is evident, for example, when one looks at changes in the distribution of newly diagnosed myeloma patients by their stage at diagnosis. In recent years, Dr. Rajkumar said, more myeloma patients are being diagnosed when their myeloma is in its earlier stages (Stage 1, for example, versus Stage 3).
We all can think of different reasons for the trend to more accurate and earlier diagnoses of myeloma. Those reasons include improved imaging techniques, improved laboratory tests, greater awareness of the diagnostic criteria for myeloma, and greater awareness of the disease itself – brought about, in part, by more treatments being available for it.
None of this means that more work shouldn't be done to get myeloma diagnosed more accurately and earlier than it is now. That is not what Dr. Rajkumar is saying.
What he is saying, however, is that, based on the work of Dr. Kyle and what can be seen in the national datasets for the U.S., it does not appear that there has been any significant change in the risk of someone in the U.S. developing multiple myeloma once you control for the person's age, sex, and race.
If you were able to compile national statistics about the incidence of myeloma that took all those factors into control, and if the statistics accurately captured all true cases of myeloma when they occurred, Dr. Rajkumar believes the statistics would not show any substantial change in the incidence of myeloma over the last 30 years.
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Boris Simkovich - Name: Boris Simkovich
Founder
The Myeloma Beacon
13 posts
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