Racial disparities in the prevalence of monoclonal gammopathies: a population-based study of 12,482 persons from the National Health and Nutritional Examination Survey.
Multiple myeloma (MM) incidence is markedly higher in blacks compared with whites, which may be related to a higher prevalence of monoclonal gammopathy of undetermined significance (MGUS). Our objective was to define the prevalence and risk factors of MGUS in a large cohort representative of the US population. Stored serum samples from the National Health and Nutritional Examination Survey (NHANES) III or NHANES 1999-2004 were available for 12,482 individuals of age ⩾50 years (2331 'blacks', 2475 Hispanics, 7051 'whites' and 625 'others') on which agarose-gel electrophoresis, serum protein immunofixation, serum-free light-chain assay and M-protein typing were performed. MGUS was identified in 365 participants (2.4%). Adjusted prevalence of MGUS was significantly higher (P<0.001) in blacks (3.7%) compared with whites (2.3%) (P=0.001) or Hispanics (1.8%), as were characteristics that posed a greater risk of progression to MM. The adjusted prevalence of MGUS was 3.1% and 2.1% for the North/Midwest versus South/West regions of the United States, respectively (P=0.052). MGUS is significantly more common in blacks, and more often has features associated with higher risk of progression to MM. A strong geographic disparity in the prevalence of MGUS between the North/Midwest versus the South/West regions of the United States was found, which has etiologic implications.
Multiple Myeloma Section, Center for Cancer Research, Metabolism Branch, National Cancer Institute, Rockville, MD, USA.
O
O
Landgren
Divsion of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, Rockville, MD, USA.
B I
BI
Graubard
Department of Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, USA.
J A
JA
Katzmann
Division of Hematology, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
R A
RA
Kyle
Multiple Myeloma Section, Center for Cancer Research, Metabolism Branch, National Cancer Institute, Rockville, MD, USA.
I
I
Ahmadizadeh
Department of Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, USA.
R
R
Clark
Division of Hematology, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
S K
SK
Kumar
Division of Hematology, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
A
A
Dispenzieri
Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA.
A J
AJ
Greenberg
Division of Hematology, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
T M
TM
Therneau
Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA.
L J
LJ
Melton
Divsion of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, Rockville, MD, USA.
N
N
Caporaso
Multiple Myeloma Section, Center for Cancer Research, Metabolism Branch, National Cancer Institute, Rockville, MD, USA.
N
N
Korde
Multiple Myeloma Section, Center for Cancer Research, Metabolism Branch, National Cancer Institute, Rockville, MD, USA.
M
M
Roschewski
Multiple Myeloma Section, Center for Cancer Research, Metabolism Branch, National Cancer Institute, Rockville, MD, USA.
R
R
Costello
Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, Hyattsville, MD, USA.
G M
GM
McQuillan
Division of Hematology, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
S V
SV
Rajkumar
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000453:epidemiology; D010265:Paraproteinemias / Q000453:epidemiology* / Q000208:ethnology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology