Exploring health disparities in diagnosing multiple myeloma

Expert Rev Hematol. 2024 Oct;17(10):749-753. doi: 10.1080/17474086.2024.2389988. Epub 2024 Aug 8.

Abstract

Background: Multiple myeloma (MM) is a plasma cell neoplasm, which accounts for 1-2% of cancers and approximately 17% of hematological malignancies in the United States each year. Fifty percent of patients with symptomatic MM have three or more primary care visits before being referred to a specialist, which is greater than any other cancer. A delay in the diagnosis of multiple myeloma has been shown to negatively impact the clinical course of the disease; patients with longer diagnostic intervals have been shown to experience shorter disease-free survival and higher rates of treatment-related complications.

Research design and methods: We performed a retrospective analysis of patients diagnosed with MM in our institution, to determine the time from the first detectable lab abnormality to the diagnosis of MM.

Results: We included 92 patients in this study. Fifty-two percent of patients had isolated anemia at the time of diagnosis. Twenty-nine percent of patients had a delay in diagnosis of ≥1 year, while 18% had a delay of ≥3 years. Nine patients in our cohort had anemia and an elevated serum total protein (31%). This group had the longest time to diagnosis with a median of 38 months.

Conclusions: Our results did not show any difference in time to diagnosis by race, ethnicity, gender, or socioeconomic status.

Keywords: ADI; MGUS; MM; Monoclonal Gammopathy of Unknown Significance; SMM; area deprivation index; multiple myeloma; smoldering multiple myeloma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Delayed Diagnosis
  • Female
  • Healthcare Disparities
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / mortality
  • Retrospective Studies