Cancer and Metastasis Reviews

, Volume 22, Issue 1, pp 87–93 | Cite as

Myeloma and race: A review of the literature

  • Michael Benjamin
  • Sreekanth Reddy
  • Otis W. Brawley


Multiple myeloma is an uncommon disease, with approximately 12,000 cases per year diagnosed in America. Blacks have had at least double the risk of being diagnosed with myeloma, and have had twice the mortality rate from the disease compared to whites 1. Research of the origins of this difference has yielded both insight and controversy. Obesity is likely a risk factor for myeloma, in both blacks and whites. Obesity is more prevalent in the black population, and this may help explain some of the increased incidence of myeloma. Also, genetic factors such as HLA antigens and family history seem to be important in explaining the differential risk of myeloma. Exposure to immunological challenges, especially urinary tract infections in black men, seems important in explaining some of the excess risk in blacks. Factors such as socioeconomic status, dietary preferences, vitamin intake, alcohol and tobacco use, either lack a consensus finding, or may not play a role in explaining the increased myeloma morbidity and mortality in blacks.

multiple myeloma race epidemiology etiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ries LAG,Eisner MP,Kosary CL,Hankey BF,Miller BA,Clegg L, andEdwards BK: SEER Cancer Statistics Review, 1973-1999., 2002. Bethesda, MD, National Cancer Institute, 1999.Google Scholar
  2. 2.
    Singh J,Dudley AW Jr,Kulig KA: Increased incidence of monoclonal gammopathy of undetermined significance in blacks and its age-related differences with whites on the basis of a study of 397 men and one woman in a hospital setting. J Lab Clin Med 116: 785-789, 1990Google Scholar
  3. 3.
    Petralia SA,Dosemeci M,Adams EE,Zahm SH: Cancer mortality among women employed in health care occupations in 24 US states, 1984-1993. Am J Ind Med 36: 159-165, 1999Google Scholar
  4. 4.
    Burnett C,Robinson C,Walker J: Cancer mortality in health and science technicians. Am J Ind Med 36: 155-158, 1999Google Scholar
  5. 5.
    Dement JM,Hensley L,Kieding S,Lipscomb H: Proportionate mortality among union members employed at three Texas refineries. Am J Ind Med 33: 327-340, 1998Google Scholar
  6. 6.
    Massoudi BL,Talbott EO,Day RD,Swerdlow SH,Marsh GM,Kuller LH: A case-control study of hematopoietic and lymphoid neoplasms: The role of work in the chemical industry. Am J Ind Med 31: 21-27, 1997Google Scholar
  7. 7.
    Cocco P,Kazerouni N,Zahm SH: Cancer mortality and environmental exposure to DDE in the United States. Environ Health Perspect 108: 1-4, 2000Google Scholar
  8. 8.
    Friedman GD,Herrinton LJ: Obesity and multiple myeloma. Cancer Causes Control 5: 479-483, 1994Google Scholar
  9. 9.
    Lewis DR,Pottern LM,Brown LM,Silverman DT,Hayes RB,Schoenberg JB,Greenberg RS,Swanson GM,Schwartz AG,Liff JM: Multiple myeloma among blacks and whites in the United States: The role of chronic antigenic stimulation. Cancer Causes Control 5: 529-539, 1994Google Scholar
  10. 10.
    Baris D,Brown LM,Silverman DT,Hayes R,Hoover RN,Swanson GM,Dosemeci M,Schwartz AG,Liff JM,Schoenberg JB,Pottern LM,Lubin J,Greenberg RS,Fraumeni JF, Jr.: Socioeconomic status and multiple myeloma among US blacks and whites. Am J Public Health 90: 1277-1281, 2000Google Scholar
  11. 11.
    Koessel SL,Theis MK,Vaughan TL,Koepsell TD,Weiss NS,Greenberg RS,Swanson GM: Socioeconomic status and the incidence of multiple myeloma. Epidemiology 7: 4-8, 1996Google Scholar
  12. 12.
    Weston B,Grufferman S,MacMillan JP,Cohen HJ: Effects of socioeconomic and clinical factors on survival in multiple myeloma. J Clin Oncol 5: 1977-1984, 1987Google Scholar
  13. 13.
    Pottern LM,Gart JJ,Nam JM,Dunston G,Wilson J,Greenberg R,Schoenberg J,Swanson GM,Liff J,Schwartz AG: HLA and multiple myeloma among black and white men: Evidence of a genetic association. Cancer Epidemiol Biomarkers Prev 1: 177-182, 1992Google Scholar
  14. 14.
    Brown LM,Gridley G,Pottern LM,Baris D,Swanso CA,Silverman DT,Hayes RB,Greenberg RS,Swanson GM,Schoenberg JB,Schwartz AG,Fraumeni JF Jr.: Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control 12: 117-125, 2001Google Scholar
  15. 15.
    Brown LM,Pottern LM,Silverman DT,Schoenberg JB,Schwartz AG,Greenberg RS,Hayes RB,Liff JM,Swanson GM,Hoover R: Multiple myeloma among blacks and whites in the United States: Role of cigarettes and alcoholic beverages. Cancer Causes Control 8: 610-614, 1997Google Scholar
  16. 16.
    Patel M,Mahlangu J,Patel J,Stevens G,Stevens W,Allard U,Mendelow B: Kaposi sarcoma-associated herpesvirus/ human herpesvirus 8 and multiple myeloma in South Africa. Diagn Mol Pathol 10: 95-99, 2001Google Scholar
  17. 17.
    Sitas F,Carrara H,Beral V,Newton R,Reeves G,Bull D,Jentsch U,Pacella-Norman R,Bourboulia D,Whitby D,Boshoff C,Weiss R: Antibodies against human herpesvirus 8 in black South African patients with cancer. N Engl J Med 340: 1863-1871, 1999Google Scholar
  18. 18.
    Nossent JC,Winkel CN,van Leeuwen JC: Multiple myeloma in the Afro-Caribbean population of Curacao. Neth J Med 43: 210-214, 1993Google Scholar
  19. 19.
    Brown LM,Linet MS,Greenberg RS,Silverman DT,Hayes RB,Swanson GM,Schwartz AG,Schoenberg JB,Pottern LM,Fraumeni JF Jr.: Multiple myeloma and family history of cancer among blacks and whites in the US Cancer 85: 2385-2390, 1999Google Scholar
  20. 20.
    Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academy Press 2002Google Scholar
  21. 21.
    Modiano MR,Villar-Werstler P,Crowley J,Salmon SE. Evaluation of race as a prognostic factor in multiple myeloma. An ancillary of Southwest Oncology Group Study 8229. J Clin Oncol 14: 974-977, 1996Google Scholar
  22. 22.
    Jorde LB,Watkins WS,Bamshad MJ: Population genomics: A bridge from evolutionary history to genetic medicine. Hum Mol Genetics 10: 2199-2207, 2001Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Michael Benjamin
    • 1
  • Sreekanth Reddy
    • 1
  • Otis W. Brawley
    • 1
  1. 1.Winship Cancer InstituteEmory UniversityAtlanta

Personalised recommendations