• R L Soutar, A A Dawson, and B J Wilson.
• Department of Haematology, Aberdeen Royal Infirmary.
• Health Bull (Edinb). 1996 May 1; 54 (3): 232-40.

Study Objective(1) To review the pattern of published world age-standardised registration rates for myeloma (ICD8 and ICD9 203) for the five Scottish regional cancer registries between 1973-77 and 1983-87. (2) To review the patterns of world age-standardised incidence and survival for myeloma in Grampian region over the time period 1960-89.DesignRetrospective analysis of cancer registration data and linked mortality data.SettingThe five Scottish regional cancer registries (East, North, North East, South East and West Scotland).PatientsIncidence: a total of 405 patients with myeloma resident in Grampian region (153 diagnosed between 1960-69, 252 diagnosed between 1980-89 inclusive). Survival: a total of 420 patients with myeloma treated in Grampian hospitals between 1968 and 1987 inclusive.Measurements And Main ResultsOn average, the world age-standardised registration rates for the five regional registries increased from 2.8 to 3.1 cases per 100,000 in males and from 1.8 to 2.4 per 100,000 in females between 1973-77 and 1983-87. No clearcut pattern in the trends for individual registries was evident for males but, in general, an increasing trend in female rates was observed for the registries with the lowest rates initially, whilst those with the highest initial rates increased only slightly or even fell. After age and sex standardisation, the annual incidence of myeloma in NE Scotland has increased by 20 per cent between 1960-69 and 1980-89, from 2.4 to 2.9 cases per 100,000 population per year with a disproportionate increase in older patients. Between the two time periods female rates remained stable or increased over all age groups while male rates fell for ages under 69 years and rose for ages above this, a pattern which was reflected in changes in the male:female ratio. The five year survival rate for all ages (14%) has not improved since 1968-72 similar to overall Scottish figures. In NE Scotland, younger patients appear to fare better, and older patients worse, compared with the overall Scottish experience.ConclusionsThe increase in myeloma incidence may be due to a combination of improved ascertainment, especially in the elderly and a possible true increase in incidence in females, suggestive of increased exposure to an aetiological agent in the past. A formal year birth cohort analysis is required to confirm this finding. The overall prognosis for myeloma remains poor, especially for elderly patients and efforts to elucidate the aetiology must continue.

15 keywords...

hide…