Multiple Myeloma Survival in A Rural Population

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Multiple Myeloma Survival in A Rural Population

Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3

Abstract

Objective: Disparities in cancer diagnosis, treatment and survival among different subgroups classified based on race, socioeconomic status and age have been previously noted. There is however a paucity of data addressing cancer disparities in rural populations. The purpose of this study is to examine multiple myeloma disease characteristics and survival in a rural population in comparison to their urban counterparts. Methods: This is a retrospective analysis of 81 multiple myeloma patients who presented to a New Mexico local hospital and cancer center from 2003 to 2013. Patients were classified to either rural or urban based on the Rural-Urban Commuting Area codes (RUCA) version 2.0, Categorization D. Results: Rural patients had longer duration of initial presenting symptom prior to diagnosis, suggesting that urban patients were more likely to seek medical attention earlier than their rural counterparts (p = 0.0037). Numerically, rural patients were more likely to be diagnosed at a more advanced disease stage (p = 0.063), while urban patients were more likely to be diagnosed at an asymptomatic stage. Patients in the rural group had a median survival of 39 months, while urban patients had a median survival of 69 months (p < 0.001). Log-rank test for equality of survivor function suggested a survival benefit in favor of the urban group. Conclusion: Rural patients with multiple myeloma had shorter survival compared to their urban counterparts. The worse outcome of the rural patients is likely a result of diverse challenges that impact health care in rural populations. It is recommended to encourage efforts aiming to enhance health care services in rural areas, in order to minimize the disparities between rural and urban populations.Multiple myeloma (MM) is estimated to account for 0.8% of all cancer cases worldwide. Approximately 47,000 males and 39,000 females are diagnosed with Multiple Myeloma annually [1]. Multiple Myeloma accounts for 0.9% of all cancer deaths; approximately 63,000 death annually worldwide. Incidence of multiple myeloma is higher in males compared to females [2]. The pathogenesis of multiple myeloma is a complex process leading to malignant replication of a plasma cell clone with secretion of a monoclonal protein causing multiple organ dysfunction. Monoclonal Gammopathy of Undetermined Significance(MGUS) consistently preceded the diagnosis of multiple myeloma [3]. MGUS progresses to myeloma or a related malignancy at a rate of 1 percent per year [4].

Authors and Affiliations

Elsayed AG, Adler W, Lebowicz Y

Keywords

Health disparities; Cancer Disparities; Rural Health; Myeloma Survival

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EP ID EP569550
DOI 10.26717/BJSTR.2017.01.000249
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