Population Level Survival for Patients with Multiple Myeloma: Variation and Growing Disparity for Patients of Minority Race or Ethnicity

Survival for patients with multiple myeloma has increased during the first decade of the 21^st century, especially in people diagnosed at a younger age. It is currently unknown whether the improvements in survival have extended equally to people of minority ethnic and racial groups. A recent publication found higher incidence and lower survival for AA versus whites. However, the above publication did not include detailed data on changes in survival in different time periods and little data is currently available for the Hispanic or Asian population. Here, we examine changes in survival in patients with myeloma by racial and ethnic group.

Using cancer registry data from the Surveillance, Epidemiology and End Results Program (SEER9), we assessed trends in 5-year relative survival for patients with multiple myeloma by racial and ethnic group, including non-Hispanic whites (nHw), African-Americans (AA), Hispanics, and Asian-Americans (Asian) for the periods 1993–97 and 2003–07. Model-based period analysis was used to obtain the most up-to-date measurements of survival. Age adjusted analysis was performed using age-standardized survival with age adjustment according to the International Cancer Survival Standard.

Overall, five-year relative survival improved for the time periods studied. Ethnic/racial analyses showed that this was the case for nHw and AA patients. Hispanic and Asian patients had the highest relative survival in the earlier time period, but smaller improvement in survival was seen in these compared to other groups (see table). Age at diagnosis varied significantly between racial and ethnic groups. Age adjusted 5-year relative survival rates showed an increase of 11.7 percentage units for nHw and smaller improvements for AA, Hispanic and Asian patients (see table.)

Although survival improved greatly for nHw with myeloma between 1993–97 and 2003–07, smaller improvements were observed for people of other racial or ethnic groups. Possible reasons for this disparity include lower rates of transplant among patients of minority ethnic or racial background, less frequent use of newer treatment options, later diagnosis, and differences in response rates to newer medications. Further explanatory studies are required to investigate these possibilities.

No relevant conflicts of interest to declare.