What are the risk factors for developing myeloma?

What are the risk factors for developing myeloma?

There are some diseases where we know a lot more about exposures or various factors that predispose. But here's what we know from the population-based and epidemiologic studies as well as, of course, by observing how our patients present and what do they look like?

One very important factor is age. As we all know, it's the disease. Older age and the average or the median age at diagnosis is between 65 to 67 or 67 to 69. So, again, older age is one risk factor. Again, that doesn't mean that it doesn't happen in younger patients. But only about 10% of myeloma patients are younger than 50. And only about 2% are younger than 40.

So those of us who take care of myeloma patients do see younger patients, but then they are obviously far rarer than older patients.

Second thing, in terms of race or ethnicity, for unknown reasons. And again, a lot of work is being done and research is going on. But in the United States, it would be African Americans. But even Africans outside of the United States, in the continent, studies show, are at greater risk. And the incidence in the African American population in the United States is about twice that of non-African Americans here. So that is another group that is at greater risk of developing multiple myeloma.

We do not fully understand the mechanisms, but people are, of course, doing the work.

It is relatively more common in men. Most of the population-based studies, it's about a 1.5 to 1 ratio, 1.4 to 1 ratio in men, although it's a rare disease. In patients where one family member is involved, other family members are at a slightly higher risk of developing multiple myeloma. Again, it's a rare disease and there are no universal guidelines for screening the families. But studies have pointed out that there could be a 3 to 4 fold increase of myeloma incidence in families.

And then there are some studies that have pointed out that perhaps increased body weight may be associated with greater risk. So these are some of the risk factors where there is an agreement and more data about myeloma.

Are people with exposure to chemicals at a greater risk of developing myeloma?

Sure. So there are those carcinogens, which have basically been highlighted in some association studies. First of what I, and perhaps someone may have done the studies and I'm not aware of those data, but it has been reported in that population. Where I live in Texas, I see, and this is observation and I have read some of the articles related to that. There's certain areas in East Texas or in western Louisiana, where apparently there is a lot of oil and gas industry and with somehow suboptimal environmental standards. And there is this suggestion that there is a higher incidence of cancer and perhaps higher incidence of blood cancers, including multiple myeloma.

So there are those observations that have been made, but clear cut association, where one has clearly identified a carcinogen and has shown association in certain populations, I think it still needs to be determined, at least based on my reading of that.