TY - JOUR
T1 - Prior cancer and risk of monoclonal gammopathy of undetermined significance
T2 - a population-based study in Iceland and Sweden
AU - Rögnvaldsson, Sæmundur
AU - Thorsteinsdóttir, Sigrun
AU - Syriopoulou, Elisavet
AU - Sverrisdottir, Ingigerdur
AU - Turesson, Ingemar
AU - Eythorsson, Elias
AU - Oskarsson, Jon Thorir
AU - Long, Thorir Einarsson
AU - Vidarsson, Brynjar
AU - Onundarson, Pall Torfi
AU - Agnarsson, Bjarni A
AU - Sigurdardottir, Margret
AU - Olafsson, Isleifur
AU - Thorsteinsdottir, Ingunn
AU - Aspelund, Thor
AU - Gislason, Gauti Kjartan
AU - Olafsson, Andri
AU - Sigurdsson, Jon Kristinn
AU - Hultcrantz, Malin
AU - Durie, Brian G M
AU - Harding, Stephen
AU - Bjorkholm, Magnus
AU - Landgren, Ola
AU - Love, Thorvardur Jon
AU - Kristinsson, Sigurdur Yngvi
PY - 2024/7/1
Y1 - 2024/7/1
N2 - There is some evidence that a prior cancer is a risk factor for the development of multiple myeloma (MM). If this is true, prior cancer should be associated with a higher prevalence or increased progression rate of monoclonal gammopathy of undetermined significance (MGUS), the precursor of MM and related disorders. Those with a history of cancer might therefore constitute a target population for MGUS screening. This two-part study is the first study to evaluate a relationship between MGUS and prior cancers. First, we evaluated whether prior cancers were associated with having MGUS at the time of screening in the Iceland Screens Treats or Prevents Multiple Myeloma (iStopMM) study that includes 75,422 individuals screened for MGUS. Next, we evaluated the association of prior cancer and the progression of MGUS to MM and related disorders in a population-based cohort of 13,790 Swedish individuals with MGUS. A history of prior cancer was associated with a modest increase in the risk of MGUS (odds ratio=1.10; 95% confidence interval: 1.00-1.20). This excess risk was limited to prior cancers in the year preceding MGUS screening. A history of prior cancer was associated with progression of MGUS, except for myeloid malignancies which were associated with a lower risk of progression (hazard ratio=0.37; 95% confidence interval: 0.16-0.89; P=0.028). Our findings indicate that a prior cancer is not a significant etiological factor in plasma cell disorders. The findings do not warrant MGUS screening or different management of MGUS in those with a prior cancer.
AB - There is some evidence that a prior cancer is a risk factor for the development of multiple myeloma (MM). If this is true, prior cancer should be associated with a higher prevalence or increased progression rate of monoclonal gammopathy of undetermined significance (MGUS), the precursor of MM and related disorders. Those with a history of cancer might therefore constitute a target population for MGUS screening. This two-part study is the first study to evaluate a relationship between MGUS and prior cancers. First, we evaluated whether prior cancers were associated with having MGUS at the time of screening in the Iceland Screens Treats or Prevents Multiple Myeloma (iStopMM) study that includes 75,422 individuals screened for MGUS. Next, we evaluated the association of prior cancer and the progression of MGUS to MM and related disorders in a population-based cohort of 13,790 Swedish individuals with MGUS. A history of prior cancer was associated with a modest increase in the risk of MGUS (odds ratio=1.10; 95% confidence interval: 1.00-1.20). This excess risk was limited to prior cancers in the year preceding MGUS screening. A history of prior cancer was associated with progression of MGUS, except for myeloid malignancies which were associated with a lower risk of progression (hazard ratio=0.37; 95% confidence interval: 0.16-0.89; P=0.028). Our findings indicate that a prior cancer is not a significant etiological factor in plasma cell disorders. The findings do not warrant MGUS screening or different management of MGUS in those with a prior cancer.
KW - Humans
KW - Iceland/epidemiology
KW - Monoclonal Gammopathy of Undetermined Significance/epidemiology
KW - Sweden/epidemiology
KW - Male
KW - Female
KW - Middle Aged
KW - Aged
KW - Risk Factors
KW - Multiple Myeloma/epidemiology
KW - Neoplasms/epidemiology
KW - Disease Progression
KW - Adult
KW - Population Surveillance
U2 - 10.3324/haematol.2023.284365
DO - 10.3324/haematol.2023.284365
M3 - Article
C2 - 38205512
SN - 1592-8721
VL - 109
SP - 2250
EP - 2255
JO - Haematologica
JF - Haematologica
IS - 7
ER -