BETA - Could screening help close the gap in care?

Could screening help close the gap in care? Knowing that myeloma has a higher incidence in the African American community in the United States, but also people of African descent around the world, would screening help? That's a really good question and a question that is being asked in the ISTOP study, the Icelandic study. In Iceland, they have a study where they have screened people over the age of 40 in Iceland, and then they're following them to see does screening have a benefit? Does screening help? One interesting thing that came up in the study is that they found actually the prevalence of smoldering myeloma. And so it's small, but they found that signal. And now the question is, is that will outcomes change if you screen large numbers? And that's going to take some time for us to figure out. In the United States, we have the PROMIS study that is run by Irene Goldbrough, which I belong to. I signed up for it because it's for either primary family members of patients that have myeloma or African Americans over the age of 50. And I guess I gave away my age just now, which is, I'm happy to be over 50. So I signed up for that. And it's a screening study. And to see, in the United States, done on African Americans, they just took my blood, tested me for MGUS, and they'll test me again in three years, to see if it's worth screening, how many lives will you save by screening for myeloma? And we don't know that yet. But being involved in studies like that, again, why did I sign up? Did I sign up for the PROMIS study because I'm a myeloma doctor? No. I signed up for that PROMIS study because I want to know myself, for my kids and my uncles and my cousins, if they should be screened in the future. I mean, the reason I signed up for the PROMIS study is really for my kids. Because if this study shows a benefit to screening, then my kids will inherit that information to know what to do with it. When we look at a high-risk population, such as a population that is at increased risk of developing myeloma, so for example, the Black population or African American population, or individuals who have multiple family members, first-degree relatives who have multiple myeloma, these individuals may not have a diagnosis themselves, but they have an increased risk for developing this particular condition. For those patients, if we do screen them, meaning screening looking for signs of the disease, looking for signs of multiple myeloma, maybe in the future it will translate to an actual screening test for the general population, which would also be important in terms of early diagnosis of multiple myeloma and then early intervention for patients who have active myeloma. Are there any drawbacks to screening? Having been screened? No. If you look at the population-wide, it could accrue a cost that may be difficult as healthcare costs rise. Does screening en masse, which will put a small burden of cost on the healthcare system, is that worth it? And I guess we don't know. But having been screened, no problem for me. And if I had known, if I had been found that I had MGUS, I would say finding if you have Because if I had MGUS, I'll never, ever, ever, ever, ever, ever, ever have my bone breaks, have anemia, I'll never have any of those multiple myeloma defining events because I know that I have MGUS and they'll follow me through time. And if my protein goes up and up and up and up and up, then they'll know what to do so I'll never get sick if I had MGUS. When I tell my patients I have MGUS, I say it's a win to know that because all those bad things should never happen to you. I think, if I had to suspect, I think there's going to be a benefit to screening. When you look at the screening studies that have been done for lung cancer, breast cancer, colon cancer, all those have shown benefit. The question is, are the numbers of myeloma great enough to balance out the cost of doing those tests?