Joseph Mikhael, MD, Chief Medical Officer at the International Myeloma Foundation explains racial disparities in the diagnosis of Multiple Myeloma
Transcription:
They don’t have the same incidents level that we see in the African population, but there are different disparities there where in fact, probably the youngest people that we know of, literally, on earth, diagnosed with myeloma are of Hispanic origin. The average age of diagnosis in myeloma is around 70 years. It’s about, 71, for example, in the Asian population, 69 in the White population, 65 or 66 in the Black population, 64, 65 in the Hispanic American population.
For reasons we don’t fully understand, they’re (Hispanic Americans) diagnosed at a younger age and sometimes that confounds a diagnosis because as primary care providers, we don’t think of myeloma in the 30s and 40s. I just had a patient in my clinic a couple weeks ago who was diagnosed in his 20s with myeloma. So yes, there are disparities across the board.
We see a similar breakdown between high-risk and standard-risk myeloma in patients that are younger. If we look at examples, the under 40 population, which I have had the privilege of trying to study and understand a little bit more. The challenge is, of course, in a disease where a lot of patients are diagnosed at an age which is close to life expectancy, it’s hard to really appreciate. If an 82-year-old person is diagnosed with myeloma and they live 5 years, we might think of that as being longer than life expectancy, but if someone’s diagnosed at 42, then 5 years is clearly not sufficient.
It’s not that younger means necessarily more aggressive myeloma. It has a similar distribution. Similarly, for example, in the African American population, the reduced mortality that I quoted is not actually a function of a worse biology. If anything, African American patients are less likely to have high-risk myeloma and are more likely to have standard-risk myeloma. It speaks about issues of delayed diagnosis and access to care.
For example, in the VA system or at least theoretically, people are treated in the same way. We see superior survival of African American patients with myeloma, then White patients with myeloma. That gives us actually, if you will, a goal line or the hope of knowing that if we can reduce the time to diagnosis, if we can enhance access to the therapies that we know have improved survival of myeloma, then we can absolutely improve the survival of all patients with myeloma.
To learn more about the International Myeloma Foundation, visit www.myeloma.org/
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