Racial disparities in incidence and outcome in multiple myeloma: a population-based study
Racial disparities in incidence and outcome in multiple myeloma: a population-based study
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DOI：
10.1182/blood-2010-07-298760
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发表时间：
2010-12-16
期刊：
影响因子：
20.3
通讯作者：
Landgren, Ola
中科院分区：
文献类型：
--
作者：
Waxman, Adam J.;Mink, Pamela J.;Landgren, Ola
多发性骨髓瘤（MM）是黑人最常见的血液恶性肿瘤。一些先前的研究表明，黑人的生存率较低;其他人则认为生存率相似。使用最初的9项监测、流行病学和最终结果登记研究，我们进行了一项大规模基于人群的研究，包括1973-2005年诊断的5798例黑人和28939例白色MM患者，随访至2006年。根据种族、年龄和诊断时间段计算经性别校正的发病率、疾病特异性生存率和相对生存率。黑人和白人的平均诊断年龄分别为65.8岁和69.8岁（P <0.001）。黑人的发病率是白人的2倍;这种差异在< 50岁的患者中更大（P = 0.002）。在整个研究期间，黑人的疾病特异性和相对生存率高于白人（P <0.001）。对于白人，5年相对生存率在1973-1993年至1994-1998年（26.3%至30.8%; P <0.001）和1994-1998年至1999-2005年（30.8%至35.0%; P = 0.004）显著增加。黑人的生存改善较小且不显著（1973- 1993至1999-2005：31.0%至34.1%; P = 0.07）。我们发现：（1）黑人发病年龄更小;（2）1973-2005年黑人生存率更高;（3）随着时间的推移，白人的生存率显著提高，黑人的变化较小，不显著，可能是由于获得新疗法的机会不平等和/或对新疗法的反应不同。（血。2010; 116（25）：5501-5506）
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. (Blood. 2010; 116(25): 5501-5506)