Myeloma incidence statistics

Myeloma is the 17th most common cancer in the UK (2012), accounting for around 1% of all new cases. In males, it is the 15th most common cancer (2% of all male cases) and the 18th in females (1% of all female cases).

In 2012, there were 4,934 new cases of myeloma in the UK: 2,772 (56%) in men and 2,162 (44%) in women, giving a male:female ratio of around 13:10.[1-4] The crude incidence rate Open a glossary item shows that there are 9 new myeloma cases for every 100,000 males in the UK and 7 for every 100,000 females.

The European age-standardised incidence (AS) rates Open a glossary item for males or females do not differ significantly between the constituent countries of the UK.[1-4]

Myeloma (C90), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Male Cases 2,361 132 214 65 2,772
Crude Rate 9.0 8.7 8.3 7.3 8.9
AS Rate 11.1 9.7 9.9 10.1 10.9
AS Rate - 95% LCL 10.6 8.0 8.6 7.6 10.5
AS Rate - 95% UCL 11.5 11.3 11.3 12.5 11.3
Female Cases 1,829 100 184 49 2,162
Crude Rate 6.7 6.4 6.7 5.3 6.7
AS Rate 7.1 6.0 6.8 6.2 7.0
AS Rate - 95% LCL 6.8 4.9 5.8 4.5 6.7
AS Rate - 95% UCL 7.4 7.2 7.8 7.9 7.3
Persons Cases 4,190 232 398 114 4,934
Crude Rate 7.8 7.5 7.5 6.3 7.7
AS Rate 8.9 7.7 8.1 7.9 8.7
AS Rate - 95% LCL 8.6 6.7 7.3 6.5 8.5
AS Rate - 95% UCL 9.1 8.7 8.9 9.4 9.0

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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Myeloma incidence is strongly related to age, with the highest incidence rates being in older men and women. In the UK between 2010 and 2012, an average of 43% of cases were diagnosed in people aged 75 years and over.[1-4]

Incidence rates rise sharply from around age 55-59, with the highest rates in the 85-89 age group, subsequently dropping in those aged 90+. Incidence rates are higher for males than females in those aged 35-39 and 45 years and over (the difference is not significant at younger ages or at age 40-44), and this gap is widest at the ages of 35 to 39, when the male:female ratio of age-specific incidence rate (to account for the different proportions of males to females in each age group) is around 20:10.[1-4]

Myeloma (C90), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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Myeloma incidence rates have increased overall in Great Britain since the late-1970s. For males, European age standardised (AS) rates increased by 58% between 1979-1981 and 2010-2012. This rise is smaller for females, with rates increasing by 52% between 1979-1981 and 2010-2012. This increase is probably due to improved diagnostic techniques and data registration, particularly in older age groups.[1-4]

Myeloma (C90), European Age-Standardised Incidence Rates, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates for myeloma in the UK have increased by 8% and 11% in males and females respectively.[5-8]

Myeloma (C90), European Age-Standardised Incidence Rates, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Myeloma rates have increased overall for all of the broad age groups in Great Britain since the late-1970s.[5-8] The largest increases have been in people aged 80+, with European AS incidence rates increasing by 78% between 1979-1981 and 2010-2012. The smallest change has been in people aged 50-59, with European AS incidence rates rising by 31% between 1979-1981 and 2010-2012.

Myeloma (C90), European Age-Standardised Incidence Rates, by Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Renshaw C, Ketley N, Moller H, et al. Trends in the incidence and survival of multiple myeloma in South East England 1985-2004. BMC Cancer 2010;10:74.
  2. Kyle RA, Therneau TM, Rajkumar SV, et al. Incidence of multiple myeloma in Olmsted County, Minnesota: Trend over 6 decades. Cancer 2004;101(11):2667-74.
  3. Turesson I, Velez R, Kristinsson SY, et al. Patterns of multiple myeloma during the past 5 decades: stable incidence rates for all age groups in the population but rapidly changing age distribution in the clinic. Mayo Clin Proc 2010;85(3):225-30.
  4. Mistry M, Parkin DM, Ahmad AS, et al. Cancer incidence in the United Kingdom: projections to the year 2030. Brit J Cancer 2011;105(11):1795-803.
  5. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  6. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  7. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  8. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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The lifetime risk of developing myeloma is around 1 in 115 for men and around 1 in 155 for women, in 2012 in the UK.[1]

The lifetime risk for myeloma has been calculated on the assumption that the possibility of having more than one diagnosis of myeloma over the course of a lifetime is very low (‘Current Probability’ method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Esteve J, Benhamou E and Raymond L. Descriptive epidemiology. IARC Scientific Publications No.128, Lyon, International Agency for Research on Cancer, pp 67-68 1994.
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Around 39,000 new cases of myeloma (C88 and C90) were diagnosed in Europe in 2012 (1% of total cancer cases). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for myeloma are in Norway for both men and women; the lowest rates are in Albania for men and Bosnia Herzegovina for women. UK myeloma incidence rates are estimated to be the ninth highest in males in Europe, and eighth highest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

More than 114,000 new cases of myeloma (C88 and C90) were diagnosed worldwide in 2012 (0.8% of total cancer cases). Myeloma incidence rates are highest in Australia/New Zealand and lowest in Western Africa, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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The most recent England-wide data for 2000-2004 showed slightly lower myeloma incidence rates for men living in more deprived  areas, though no differences were reported for women.[1] In this analysis, levels of deprivation were measured according to the Income Domain of the Index of Multiple Deprivation (IMD) 2007, and using information on benefit receipt as a proxy indicator for income deprivation, patients were allocated a deprivation score based on their area of residence.

Data from the Haematological Malignancy Research Network (HMRN) region for 2004-2009 showed a similar result, with lower rates of myeloma incidence in the more deprived areas for both sexes combined.[2] Rather than reflecting disease aetiology, these observations are compatible with the theory that socio-economic factors impact on the likelihood of recognising symptoms (especially the non-specific symptoms common in myeloma) and seeking medical care.[3,4]

References

  1. National Cancer Intelligence Network. Cancer incidence by deprivation England 1999-2004. London: NCIN, 2008.
  2. Smith A, Howell D, Patmore R, et al. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Brit J Cancer 2011;105(11):1684-92.
  3. Waller J, Robb K, Stubbings S, et al. Awareness of cancer symptoms and anticipated help seeking among ethnic minority groups in England. Brit J Cancer 2009;101 Suppl 2:S24-30.
  4. Robb K, Stubbings S, Ramirez A, et al. Public awareness of cancer in Britain: a population-based survey of adults. Brit J Cancer 2009;101 Suppl 2:S18-23.
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Some otherwise healthy people can produce myeloma-causing cells, resulting in the asymptomatic condition MGUS. Rates of progression Open a glossary item from MGUS to myeloma are low at around 1% per year,[1] but all myeloma patients have MGUS as a precursor to their myeloma.[2]

Although cases of MGUS are not systematically recorded by the UK cancer registries Open a glossary item, information on these diagnoses is routinely collected in the Haematological Malignancy Research Network (HMRN) region in the north of England. In 2004-2009 there were on average 4.9 cases of MGUS per 100,000 people per year.[3] Like myeloma, MGUS is more common in men than women, with average age-standardised Open a glossary item rates of 6.3 cases per 100,000 men and 3.5 cases per 100,000 women in the HMRN region in 2004-2010.[3]

UK estimates based on data from the HMRN region show that the age and sex distribution of MGUS patients is very similar to that of myeloma patients.[3]

Monoclonal Gammopathy of Undetermined Significance (MGUS, ICD-O-3 9765/1), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK estimates based on data from HMRN region, 2004-2010

MGUS prevalence has been found to be twice as high in black Ghanaian men,[4] and in black men of African origin living in America, compared with white men, suggesting that race-related susceptibility to MGUS and myeloma could be genetic rather than due to environmental factors.[5]

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Age-standardised Open a glossary item rates for White males with myeloma (ICD-10 C88-C90) range from 6.1 to 6.5 per 100,000. Rates for Asian males are similar, ranging from 3.6 to 6.4 per 100,000, whereas the rates for Black males are significantly higher, ranging from 10.9 to 18.2 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 3.9 to 4.2 per 100,000. Rates for Asian females are similar, ranging from 2.3 to 4.4 per 100,000, whereas the rates for Black females are significantly higher, ranging from 6.6 to 11.5 per 100,000.[1]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For myeloma, 17,357 cases were identified; 18% had no known ethnicity.

A similar ethnic pattern has been observed in the UK for almost 40 years, with myeloma occurring around twice as frequently in African Americans as Caucasians.[2] It appears that, in comparison with white people, black people have younger myeloma onset,[3] and a higher incidence of MGUS (though no difference in progression risk).[4,5] However, the reasons underpinning these ethnic differences have yet to be explained, and are currently the subject of much research.[4,6]

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Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 12,500 people were still alive at the end of 2006, up to ten years after being diagnosed with myeloma.[1]

Myeloma (C88 and C90), One-, Five- and Ten-Year Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 1,595 5,247 6,921
Female 1,294 4,175 5,544
Persons 2,889 9,422 12,465

Worldwide, it is estimated that there were more than 210,000 men and women still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network. One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN, 2010.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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