Multiple Myeloma Ethnicity: Reversing Racial Outcome Disparities

Multiple myeloma disproportionally affects Black people more than any other racial or ethnic group, according to statistics from the NCI.

Below, you’ll find a comparison of the number of new cases (per 1,000 people) of multiple myeloma among various racial and ethnic groups:

But why does this condition affect Black people more than other groups?

Researchers in one 2020 medical literature review investigated the role of genetic differences in the risk of multiple myeloma. They found that certain genetic components may play a large role in myeloma risk.

According to researchers, there are certain high risk gene variants that may place people of African descent at a higher risk of developing multiple myeloma.

For example, researchers found that people in the highest genetic risk category (the top 10 percent) had an 80 percent increased risk of developing multiple myeloma than those in lower genetic risk categories.

In a 2018 study, researchers found that a specific set of genetic abnormalities was associated with multiple myeloma risk.

According to study researchers, people with African ancestry who had multiple myeloma were more likely to have those specific genetic abnormalities than those with the lowest African ancestry.

According to NCI statistics, Black people with multiple myeloma are almost twice as likely as white people to die from the disease.

Research from 2022 suggests that this huge disparity in death rates is most likely due to a variety of factors — many of which involve different types of healthcare barriers.

Misdiagnoses and late diagnoses

Misdiagnoses and late diagnoses for conditions like multiple myeloma are more common in populations that lack access to proper medical treatment, according to the NCI.

Not receiving an early diagnosis — or even a diagnosis at all — can lead to late-stage diagnoses that are much harder to treat effectively.

Barriers to accessing healthcare

Many people in the United States face barriers that make it difficult to access healthcare services, which can lead to fewer opportunities for prevention, diagnosis, and treatment.

Some of these barriers include:

• lack of income or proper transportation
• poor health education
• no health insurance
• no paid medical leave from work

Lack of access to novel treatments

When people with multiple myeloma don’t have access to the most effective treatment options, it can significantly lower their chances of remission.

Researchers in one large 2017 research review found that the use of novel therapies for multiple myeloma, like certain medications and stem cell transplants, were lowest in Black people after diagnosis.

Underrepresentation in clinical trials

According to medical literature, while Black people encompass 14 percent of the U.S. population, they only represent a small percentage of clinical trial participants — as low as 4.5 percent of participants in multiple myeloma trials.

A lack of representation in these trials can negatively affect the treatment outcomes of Black people with multiple myeloma.

According to the American Cancer Society, a lack of symptoms in the early stage of the disease can make it more difficult to diagnose multiple myeloma early.

People who do have symptoms may notice:

• bone pain, often in the back, hips, or skull
• weakness in the bones, sometimes resulting in fractures
• low red blood cell count, which can cause anemia
• low white blood cell count, which can cause increased infections
• low blood platelets, which can cause problems with blood clotting
• high blood calcium levels and hypercalcemia symptoms
• severe pain in the back from pressure on the spinal cord
• numbness and muscle weakness, especially in the legs
• pins and needles in the fingers, toes, or extremities
• confusion, dizziness, or stroke-like symptoms, from thick blood
• symptoms of kidney damage, like weakness, itching, or swollen legs

Recognizing symptoms and receiving treatment early is important

Because many of the symptoms of multiple myeloma can also be associated with other conditions, getting a diagnosis can be difficult. However, just like any other type of cancer, early diagnosis and treatment are important.

In fact, the Multiple Myeloma Research Foundation shares that early treatment via a stem cell transplant may give people the best chance of staying in remission for the longest time.

And researchers in a 2021 research review suggest that early diagnosis and treatment for multiple myeloma — especially the precancerous smoldering multiple myeloma — is essential in helping both prevent myeloma and improve remission rates.

If you think you may have symptoms, ask a doctor for the following diagnostic tests

If you’re concerned you may have symptoms of multiple myeloma, ask a doctor or other healthcare professional for a closer look with the following diagnostic tests:

• Labs. Blood tests, like the serum protein electrophoresis (SPEP) test, can check for antibodies that are commonly associated with multiple myeloma. Standard blood work, such as a complete blood count (CBC), can also be used to check for changes in your blood, bones, and other organs that multiple myeloma can cause.
• Imaging. CT scans, MRIs, and X-rays can all check for changes in your bones that might be the result of multiple myeloma. Imaging tests also help doctors identify any changes to your organs that can happen because of multiple myeloma.
• Biopsy. Biopsies play a huge role in diagnosing multiple myeloma — especially a bone marrow biopsy. By taking a bone marrow biopsy, a doctor can check for myeloma cells in your bone marrow. They can also analyze those cells to help determine your outlook if cancer is present.

Consider participating in clinical trials

If you’ve received a multiple myeloma diagnosis and are interested in exploring your treatment options, consider participating in clinical trials.

More Black representation in clinical trials that explore genetic components or new treatments can help improve the early diagnosis and treatment of multiple myeloma for Black Americans.

What can I do to lower my risk of developing multiple myeloma?

According to the American Cancer Society, preventing multiple myeloma can be difficult because most of the risk comes from things that are hard to avoid or change, like genetics. But interventions like genetic screening can help you better understand your individual risk.

Where can I access free or low cost screenings for multiple myeloma?

There are no screening tests for multiple myeloma, but routine visits with a primary care doctor may detect early signs before the disease causes symptoms.

If you or your doctor suspect that you have multiple myeloma, blood work and imaging are the next steps toward diagnosis.

What are the best treatment options for multiple myeloma?

Most cases of multiple myeloma are treated with surgery, chemotherapy, radiation, or a combination of these approaches.

In some cases, your doctor might recommend a stem cell transplant, which may help you stay in remission from multiple myeloma for longer.