Journal of Clinical Oncology, Vol 12, 1577-1583, Copyright © 1994 by American Society of Clinical Oncology
Incidence of multiple myeloma in Olmsted County, Minnesota: 1978 through 1990, with a review of the trend since 1945
RA Kyle, CM Beard, WM O'Fallon and LT Kurland
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
PURPOSE: Incidence rates of multiple myeloma appear to have increased in
recent decades, but it is difficult to compare the incidence rates over
time because of changes in laboratory procedures, differences in diagnostic
criteria, and variations in indexing of medical records. However, Olmsted
County, Minnesota, provides a rare opportunity to minimize these
limitations, because the medical care has been provided mainly by the Mayo
Clinic. PATIENTS AND METHODS: Records of Olmsted County residents with a
diagnosis of multiple myeloma from January 1, 1978 through December 31,
1990 were reviewed. Criteria for diagnosis and residency were the same as
in previous Olmsted County studies. RESULTS: The incidence rate per 100,000
age-adjusted to the 1950 United States white population was 5.4 for males
and 2.8 for females; the overall rate was 4.1. The rates were age-adjusted
to the 1950 United States population for comparison with earlier data from
this population. The rates increased with age for both sexes. There was no
significant change in incidence rates from 1945 through 1990. A comparison
of the median age for Olmsted County patients with the age of those
referred to the Mayo Clinic from elsewhere indicated that the local
patients were appreciably older (74 v. 62 years, respectively). Thirty-two
of 55 patients (58%) with multiple myeloma from 1978 through 1990 had a
monoclonal plasma-cell proliferative process before the diagnosis of
multiple myeloma. CONCLUSION: The incidence rate of multiple myeloma in
Olmsted County, Minnesota, has not changed significantly during the past 46
years. We believe that reports of increasing rates over time are mainly due
to improved case ascertainment.
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