Andres Martin, Feller Anita, Arndt Volker
Department of Haematology and Central Haematology Laboratory, Inselspital Bern, University Hospital and University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland; Department for BioMedical Research (DBMR), Inselspital Bern, University Hospital and University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Seilergraben 49, CH-8001 Zurich, Switzerland.
Cancer Epidemiol. 2018 Apr;53:105-110. doi: 10.1016/j.canep.2018.01.015. Epub 2018 Feb 6.
Treatment of multiple myeloma has changed considerably over the last two decades with remarkable reduction in mortality rates in clinical trials and in population-based studies. Since health care systems and patient management differ between countries, population-based data from cancer registries with high coverage may provide further insight into real-life achievements and unmet needs. We report on the first population-based nation-wide study of incidence, mortality and survival of multiple myeloma in Switzerland covering the era of autologous stem cell transplantation and the first proteasome inhibitors and immunomodulatory drugs.
We performed a retrospective registry study with data from the National Institute for Cancer Epidemiology and Registration (NICER) database in Switzerland from 1994 to 2013.
We identified 5770 patients with multiple myeloma. Incidence has increased from 419 new cases per year in 1994-1998 to 557 new cases per year in 2009-2013 while the age-adjusted incidence rate remained stable at 4.7-5.0 per 100'000 person-years. Five- and 10-year relative survival increased from 32.6% (95%CI 29.3-36.0) and 17.8% (95%CI 14.9-21.0) in 1994-1998 to 46.4% (95%CI 43.3-49.3) and 25.0% (95%CI 21.9-28.3) in 2009-2013.
The increase in incidence can be attributed to demographic changes. There is a trend to longer relative survival in all age groups with substantial increase in myeloma patients aged less than 75 years and only minimal changes in older persons.
在过去二十年中，多发性骨髓瘤的治疗发生了显著变化，临床试验和基于人群的研究中的死亡率显著降低。由于各国的医疗保健系统和患者管理方式不同，来自高覆盖率癌症登记处的基于人群的数据可能会进一步深入了解实际取得的成果和未满足的需求。我们报告了瑞士首次基于全国人群的多发性骨髓瘤发病率、死亡率和生存率研究，该研究涵盖了自体干细胞移植时代以及首批蛋白酶体抑制剂和免疫调节药物的使用时期。
我们利用瑞士国家癌症流行病学和登记研究所（NICER）数据库1994年至2013年的数据进行了一项回顾性登记研究。
我们确定了5770例多发性骨髓瘤患者。发病率从1994 - 1998年每年419例新发病例增加到2009 - 2013年每年557例新发病例，而年龄调整发病率保持稳定，为每10万人年4.7 - 5.0例。5年和10年相对生存率从1994 - 1998年的32.6%（95%CI 29.3 - 36.0）和17.8%（95%CI 14.9 - 21.0）增加到2009 - 2013年的46.4%（95%CI 43.3 - 49.3）和25.0%（95%CI 21.9 - 28.3）。
发病率的增加可归因于人口结构变化。所有年龄组的相对生存时间都有延长的趋势，75岁以下骨髓瘤患者的生存率大幅提高，而老年人的变化很小。
