Multiple myeloma epidemiology and patient geographic distribution in Canada: A population study

Abstract

Background Multiple myeloma (MM) is a malignancy of mature plasma cells. Environmental risk factors identified for this malignancy, among others, include farming and exposure to pesticides. Methods Using 3 independent population‐based databases (the Canadian Cancer Registry, le Registre Québécois du Cancer, and Canadian Vital Statistics), this study analyzed patients’ clinical characteristics and the incidence, mortality, and geographic distribution of MM cases in Canada during 1992‐2015. Results In total, ~32,065 patients were identified, and 53.7% were male. The mean age at the time of diagnosis was 70 ± 12.1 years. The average incidence rate in Canada was 54.29 cases per million individuals per year, and linear regression modeling showed a steady rise in the annual rate of 0.96 cases per million individuals per year. At the provincial level, Quebec and Ontario had significantly higher incidence rates than the rest of Canada. An analysis of individual municipalities and postal codes showed lower incidence rates in large metropolitan areas and in high‐latitude regions of the country, whereas high incidence rates were observed in smaller municipalities and rural areas. Land use analysis demonstrated increased density of crop farms and agricultural industries in high‐incidence areas. A comparison with the available data from 2011‐2015 showed several consistent trends at provincial, municipal, and regional levels. Conclusions These results provide a comprehensive analysis of the MM burden in Canada. Large metropolitan cities as well as high‐latitude regions were associated with lower MM incidence. Higher incidence rates were noted in smaller cities and rural areas and were associated with increased density of agricultural facilities.

Epidemiology and Patient Distribution of Oral Cavity and Oropharyngeal SCC in Canada

“…Incidence and mortality data for oral cavity and oropharyngeal malignancies were extracted from 3 distinct but complementary population-based cancer databases (Canadian Cancer Registry [CCR], Le Registre Québécois du Cancer [LRQC], and Canadian Vital Statistics [CVS]) using the previously reported and established methods. 11 -34…”

Global, Regional, and National Burden of Multiple Myeloma from 1990 to 2019: Estimates from the 2019 Global Burden of Disease study

“…In recent decades, epidemiological studies of MM have mainly focused on individuals and several countries. [11][12][13][14][15] The latest study was conducted based on Global Burden of Disease Study 2016. [16] The study was highly signi cant and evaluated the association between stem-cell transplant, lenalidomide and bortezomib approval and the decreasing trend in high SDI regions.…”

Incidence of acute myeloid leukemia: A regional analysis of Canada

“…In Canada, postal codes consist of letters and numbers (eg, H3G 1A4), where the first 3 characters (eg, the FSA) define a region in the country; there are more than 1600 FSAs across Canada. For calculating rural and urban incidence rates by FSA, we used the previously described classification by Canada Post, which is based on the second character in the FSA, for rural delivery areas versus urban delivery areas . FSAs whose second character is 0 are considered rural, whereas FSAs whose second character is 1 to 9 are considered urban.…”

“…The initial manuscript underwent 2 rounds of peer review by 5 experts in the field from May 10 to September 8, 2018, at which point the article was endorsed for publication. For this initial study on AML, the research team followed the same approved protocol for data analysis that was used for a series of other published articles within approximately the last 2 years . In this study, we present additional analyses, which we hope will help to address the criticisms brought forward by experts in the research community.…”