Dr Zonder on the Epidemiology of Multiple Myeloma

"A higher risk of MGUS leads to a higher risk of myeloma in older people and in Black people compared with other populations."

Jeffrey Zonder, MD, a professor in the Department of Oncology at the Barbara Ann Karmanos Cancer Institute and Wayne State University School of Medicine, discussed the current epidemiological landscape of multiple myeloma, highlighting racial disparities and the role of precursor conditions such as monoclonal gammopathy of undetermined significance (MGUS) in disease development.

Multiple myeloma is characterized by the malignant proliferation of clonal plasma cells and is consistently preceded by MGUS, an asymptomatic premalignant state. The detection of MGUS is typically incidental and most often identified through routine blood work showing abnormal protein levels or immunoglobulin imbalances.

Epidemiologic data indicate that the incidence of multiple myeloma is approximately twice as high in non-Hispanic Black individuals compared with the general United States population. This disparity is well documented, with studies showing a significantly elevated risk of diagnosis in this population. In contrast, the incidence among non-Hispanic White and Hispanic individuals is relatively comparable.

Zonder emphasized the importance of improving awareness of multiple myeloma risk in high-incidence populations, particularly among primary care providers who are often the first to detect MGUS during routine evaluations. Increased clinical vigilance may support earlier diagnosis, timely risk stratification, and referral to hematology/oncology specialists, potentially reducing disparities in treatment initiation and outcomes.

Ongoing research is focused on elucidating the genetic and biologic differences contributing to MGUS prevalence and multiple myeloma progression across racial and ethnic groups, which may ultimately inform targeted screening strategies and precision medicine approaches in the future.