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Trends in the incidence and survival of multiple myeloma in South East England 1985-2004.

Renshaw C, Ketley N, Møller H, Davies EA - BMC Cancer (2010)

Bottom Line: There was a tendency for better survival in patients resident in the most affluent areas, but this did not reach statistical significance.Relative survival was higher for younger patients although we found significant improvements in 1-year relative survival for male patients over 60 years old.Future studies should investigate the influence of ethnicity on incidence and survival, and the effect of specific treatments on survival and quality of life.

View Article: PubMed Central - HTML - PubMed

Affiliation: King's College London, Thames Cancer Registry, 42 Weston Street, London, SE1 3QD, UK. christine.renshaw@kcl.ac.uk

ABSTRACT

Background: Multiple myeloma is an uncommon cancer with a poor prognosis. Its incidence is expected to increase due to ageing populations and better diagnosis, and new treatments have been developed to improve survival. Our objective was to investigate trends in the epidemiology and survival of multiple myeloma for South East England.

Methods: Data on 15,010 patients diagnosed with multiple myeloma between 1985 and 2004 was extracted from the Thames Cancer Registry database. We calculated the yearly age-standardised incidence rates for males and females and age-specific incidence rates in 10-year age groups for both sexes combined. We also explored geographical variation in incidence across primary care trusts. We then used period analysis to calculate trends in 1- and 5-year relative survival over the 15 years 1990-2004, comparing survival by sex and by age group 59 years and below versus 60 years and above. Finally, we investigated 5-year relative survival for the period 2000-2004 by socio-economic deprivation, assigning patients to quintiles of deprivation using the Income Domain of the Index of Multiple Deprivation 2004 based on postcode of residence.

Results: The incidence of multiple myeloma was higher in males than in females and in patients over 70, throughout the period 1985-2004. No obvious geographical pattern of incidence by primary care trust emerged. The 1- and 5-year relative survival of male and female patients increased in both age groups and was statistically significant in males aged over 60. There was a tendency for better survival in patients resident in the most affluent areas, but this did not reach statistical significance.

Conclusions: The trends in incidence of multiple myeloma in males and females are similar to that reported from other western populations. Relative survival was higher for younger patients although we found significant improvements in 1-year relative survival for male patients over 60 years old. The improved survival demonstrated for patients of all ages is likely to reflect increased detection, earlier diagnosis and the introduction of new treatments. Future studies should investigate the influence of ethnicity on incidence and survival, and the effect of specific treatments on survival and quality of life.

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Relative survival by period of follow-up for patients with myeloma in South East England 1990-2004. 1- and 5-year estimates with 95% confidence intervals.
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Figure 4: Relative survival by period of follow-up for patients with myeloma in South East England 1990-2004. 1- and 5-year estimates with 95% confidence intervals.

Mentions: Relative survival was higher for the younger age group than for the older group in both males and females (Figures 4). There was also evidence of increasing relative survival over time for both sexes in each age group. Figure 4 shows the 1- and 5-year estimates of relative survival for patients aged 59 and below at diagnosis, by sex for the three follow-up periods. This group had a higher overall relative survival in all of the follow-up periods. For males the 5-year relative survival increased from 36% to 46% and 47%, with the largest improvement being between the 1990-1994 and 1995-1999 periods of follow-up. For females a steady increase was seen for each of the follow-up periods with 5-year relative survival yielding figures of 40% to 45% and 56%, respectively. Figure 4 shows the 1- and 5-year estimates of relative survival of patients aged 60 and above, by sex for the three follow-up periods. This older age group had a lower overall relative survival in all follow-up periods. For males the 5-year relative survival increased from 14% to 18% and 23%. Similarly in females, survival increased from 17% to 18% and 21% for each of the periods of follow-up. The 1-year estimates of relative survival showed a very similar pattern of improving survival over each of the three periods of follow-up, with a significant improvement in survival trend in the 1-year estimates in patients aged 60 and over. We also found an improvement in 5-year survival in males in the older age group over the time period.


Trends in the incidence and survival of multiple myeloma in South East England 1985-2004.

Renshaw C, Ketley N, Møller H, Davies EA - BMC Cancer (2010)

Relative survival by period of follow-up for patients with myeloma in South East England 1990-2004. 1- and 5-year estimates with 95% confidence intervals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2837016&req=5

Figure 4: Relative survival by period of follow-up for patients with myeloma in South East England 1990-2004. 1- and 5-year estimates with 95% confidence intervals.
Mentions: Relative survival was higher for the younger age group than for the older group in both males and females (Figures 4). There was also evidence of increasing relative survival over time for both sexes in each age group. Figure 4 shows the 1- and 5-year estimates of relative survival for patients aged 59 and below at diagnosis, by sex for the three follow-up periods. This group had a higher overall relative survival in all of the follow-up periods. For males the 5-year relative survival increased from 36% to 46% and 47%, with the largest improvement being between the 1990-1994 and 1995-1999 periods of follow-up. For females a steady increase was seen for each of the follow-up periods with 5-year relative survival yielding figures of 40% to 45% and 56%, respectively. Figure 4 shows the 1- and 5-year estimates of relative survival of patients aged 60 and above, by sex for the three follow-up periods. This older age group had a lower overall relative survival in all follow-up periods. For males the 5-year relative survival increased from 14% to 18% and 23%. Similarly in females, survival increased from 17% to 18% and 21% for each of the periods of follow-up. The 1-year estimates of relative survival showed a very similar pattern of improving survival over each of the three periods of follow-up, with a significant improvement in survival trend in the 1-year estimates in patients aged 60 and over. We also found an improvement in 5-year survival in males in the older age group over the time period.

Bottom Line: There was a tendency for better survival in patients resident in the most affluent areas, but this did not reach statistical significance.Relative survival was higher for younger patients although we found significant improvements in 1-year relative survival for male patients over 60 years old.Future studies should investigate the influence of ethnicity on incidence and survival, and the effect of specific treatments on survival and quality of life.

View Article: PubMed Central - HTML - PubMed

Affiliation: King's College London, Thames Cancer Registry, 42 Weston Street, London, SE1 3QD, UK. christine.renshaw@kcl.ac.uk

ABSTRACT

Background: Multiple myeloma is an uncommon cancer with a poor prognosis. Its incidence is expected to increase due to ageing populations and better diagnosis, and new treatments have been developed to improve survival. Our objective was to investigate trends in the epidemiology and survival of multiple myeloma for South East England.

Methods: Data on 15,010 patients diagnosed with multiple myeloma between 1985 and 2004 was extracted from the Thames Cancer Registry database. We calculated the yearly age-standardised incidence rates for males and females and age-specific incidence rates in 10-year age groups for both sexes combined. We also explored geographical variation in incidence across primary care trusts. We then used period analysis to calculate trends in 1- and 5-year relative survival over the 15 years 1990-2004, comparing survival by sex and by age group 59 years and below versus 60 years and above. Finally, we investigated 5-year relative survival for the period 2000-2004 by socio-economic deprivation, assigning patients to quintiles of deprivation using the Income Domain of the Index of Multiple Deprivation 2004 based on postcode of residence.

Results: The incidence of multiple myeloma was higher in males than in females and in patients over 70, throughout the period 1985-2004. No obvious geographical pattern of incidence by primary care trust emerged. The 1- and 5-year relative survival of male and female patients increased in both age groups and was statistically significant in males aged over 60. There was a tendency for better survival in patients resident in the most affluent areas, but this did not reach statistical significance.

Conclusions: The trends in incidence of multiple myeloma in males and females are similar to that reported from other western populations. Relative survival was higher for younger patients although we found significant improvements in 1-year relative survival for male patients over 60 years old. The improved survival demonstrated for patients of all ages is likely to reflect increased detection, earlier diagnosis and the introduction of new treatments. Future studies should investigate the influence of ethnicity on incidence and survival, and the effect of specific treatments on survival and quality of life.

Show MeSH
Related in: MedlinePlus