title: Trends in the incidence and survival of multiple myeloma in South East England 1985-2004.
abstract: BACKGROUND
  Multiple myeloma is an uncommon cancer with a poor prognosis. Its incidence is expected to increase due to ageing populations and better diagnosis, and new treatments have been developed to improve survival. Our objective was to investigate trends in the epidemiology and survival of multiple myeloma for South East England.
  
  
  METHODS
  Data on 15,010 patients diagnosed with multiple myeloma between 1985 and 2004 was extracted from the Thames Cancer Registry database. We calculated the yearly age-standardised incidence rates for males and females and age-specific incidence rates in 10-year age groups for both sexes combined. We also explored geographical variation in incidence across primary care trusts. We then used period analysis to calculate trends in 1- and 5-year relative survival over the 15 years 1990-2004, comparing survival by sex and by age group 59 years and below versus 60 years and above. Finally, we investigated 5-year relative survival for the period 2000-2004 by socio-economic deprivation, assigning patients to quintiles of deprivation using the Income Domain of the Index of Multiple Deprivation 2004 based on postcode of residence.
  
  
  RESULTS
  The incidence of multiple myeloma was higher in males than in females and in patients over 70, throughout the period 1985-2004. No obvious geographical pattern of incidence by primary care trust emerged. The 1- and 5-year relative survival of male and female patients increased in both age groups and was statistically significant in males aged over 60. There was a tendency for better survival in patients resident in the most affluent areas, but this did not reach statistical significance.
  
  
  CONCLUSIONS
  The trends in incidence of multiple myeloma in males and females are similar to that reported from other western populations. Relative survival was higher for younger patients although we found significant improvements in 1-year relative survival for male patients over 60 years old. The improved survival demonstrated for patients of all ages is likely to reflect increased detection, earlier diagnosis and the introduction of new treatments. Future studies should investigate the influence of ethnicity on incidence and survival, and the effect of specific treatments on survival and quality of life.
authors.affiliation: King's College London, Thames Cancer Registry, 42 Weston Street, London, SE1 3QD, UK. christine.renshaw@kcl.ac.uk
authors.forename: Christine
authors.initials: C
authors.lastname: Renshaw
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ketley
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davies
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008495:Medical Oncology / Q000639:trends; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013997:Time Factors