King's College London, Thames Cancer Registry, 42 Weston Street, London, SE1 3QD, UK.
BMC Cancer. 2010 Mar 1;10:74. doi: 10.1186/1471-2407-10-74.
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.
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.
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.
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.
多发性骨髓瘤是一种罕见的癌症，预后较差。由于人口老龄化和更好的诊断，其发病率预计会增加，并且已经开发出新的治疗方法来提高生存率。我们的目的是研究东南英格兰多发性骨髓瘤的流行病学和生存趋势。
从泰晤士癌症登记处数据库中提取了 1985 年至 2004 年间诊断出的 15010 名多发性骨髓瘤患者的数据。我们计算了男性和女性的每年年龄标准化发病率，并计算了两性合并的 10 年年龄组的年龄特异性发病率。我们还探索了初级保健信托机构之间发病率的地理差异。然后，我们使用期间分析来计算 1990-2004 年 15 年间 1 年和 5 年相对生存率的趋势，比较了性别和年龄组 59 岁及以下与 60 岁及以上的生存率。最后，我们根据社会经济贫困程度调查了 2000-2004 年期间的 5 年相对生存率，根据居住地址的邮政编码将患者分配到 2004 年多维度贫困指数收入域的五个贫困程度五分位数中。
1985-2004 年期间，多发性骨髓瘤的发病率在男性中高于女性，在 70 岁以上的患者中也高于女性。没有明显的按初级保健信托机构划分的发病率地理模式。1 年和 5 年的男性和女性患者的相对生存率在两个年龄组中均有所提高，60 岁以上男性的生存率提高具有统计学意义。居住在最富裕地区的患者的生存情况较好，但没有达到统计学意义。
男性和女性多发性骨髓瘤发病率的趋势与其他西方国家报告的趋势相似。尽管我们发现 60 岁以上男性患者的 1 年相对生存率显著提高，但年轻患者的相对生存率较高。所有年龄段患者的生存改善可能反映了检测的增加、更早的诊断和新治疗方法的引入。未来的研究应该调查种族对发病率和生存率的影响，以及特定治疗方法对生存率和生活质量的影响。
