Changing incidence of myeloproliferative neoplasms: trends and subgroup risk profiles in the USA, 1973-2011.

PURPOSE

Recent diagnostic and cancer reporting changes influencing myeloproliferative neoplasms (MPNs) encourage the assessment of trends and examination of the recently identified MPN subtypes: polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), across the age continuum by race and ethnicity.

METHODS

Surveillance, Epidemiology, and End Results data provided MPN incidence data since 1973 and MPN subtype data since 2001. Joinpoint regression estimated annual percent changes. Poisson regression estimated risk ratios.

RESULTS

The 2005 JAK2 V617F discovery and the 2008 WHO diagnostic guideline for the JAK2 V617F mutation coincide with a 31 % increase in ET and a 21 % decrease in PV incidence rates. We found that younger women had a 13-33 % higher ET risk and that women under the age of 34 had a 58 % higher PMF risk, relative to men. Blacks, aged 35-49 with a higher ET risk, also had a 69 % higher PMF risk relative to whites.

CONCLUSION

Demographic characteristic of ET and PMF patients may be useful for improving risk prediction and informing clinical screening and treatment strategies. Changing guidelines, new discoveries, and in-depth analysis of a large population-based study have implications for accurately identifying incident cases of MPNs, MPN subgroups, and health resource planning.