RESUMO
Background Monoclonal gammopathy of undetermined significance (MGUS) is the premalignant condition of multiple myeloma (MM). Given a lack of population-based screening for MGUS and its asymptomatic nature, the epidemiology of MGUS remains unknown. This study estimated age- and race/ethnicity-specific MGUS incidence and preclinical duration from MGUS to MM in the United States. Methods A previously published modeling approach was used to calculate national MGUS incidence using estimates of MGUS prevalence, MM incidence, MM-specific and all-cause mortality, and population age distribution from the National Health and Nutrition Examination Survey, 1999-2004, and Surveillance, Epidemiology, and End Results, 2000-2021. The estimated MGUS prevalence was divided by MGUS incidence to obtain preclinical duration of MM. Results MGUS incidence for non-Hispanic white (NHW) populations was 52, 86, 142, and 181 and for non-Hispanic black (NHB) population was 110, 212, 392, and 570 per 100,000 person-years at ages 50, 60, 70, and 80, respectively. The average preclinical duration was 20.5 (95% confidence interval, CI: 16.5, 26.1) years for the NHW population and 14.2 (95% CI: 11.5, 17.6) years for the NHB population. The cumulative risk of developing MGUS in age 50-85 was 2.8% (95% CI: 1.7%, 4.2%) for the NHW population and 6.1% (95% CI: 3.8%, 10.0%) for the NHB population. Conclusion NHB populations had a higher MGUS incidence rate at all ages and a shorter preclinical duration of MM compared to their NHW counterparts. Impact This study provides insights into the epidemiology of MGUS and enhances our understanding of the natural history of MM.
RESUMO
Multiple myeloma (MM) is a hematological malignancy that is consistently preceded by an asymptomatic condition, monoclonal gammopathy of undetermined significance (MGUS). Disparities by age, gender, and race/ethnicity in both MGUS and MM are well-established. However, it remains unclear whether these disparities can be explained by increased incidence of MGUS and/or accelerated progression from MGUS to MM. Here, we fit a mathematical model to nationally representative data from the United States and showed that the difference in MM incidence can be explained by an increased incidence of MGUS among male and non-Hispanic Black populations. We did not find evidence showing differences in the rate of progression from MGUS to MM by either gender or race/ethnicity. Our results suggest that screening for MGUS among high-risk groups (e.g., non-Hispanic Black men) may hold promise as a strategy to reduce the burden and MM health disparities.
Assuntos
Neoplasias Hematológicas , Gamopatia Monoclonal de Significância Indeterminada , Mieloma Múltiplo , Humanos , Doenças Assintomáticas , Mieloma Múltiplo/epidemiologia , Disparidades nos Níveis de Saúde , Fatores Sexuais , Grupos Raciais , EtnicidadeRESUMO
This study examined the use of high dosages of ultraviolet germicidal irradiation (UVGI) (253.7 nm) to deal with various concentrations of air pollutants, such as formaldehyde (HCHO), total volatile organic compounds (TVOC), under various conditions of humidity. A number of irradiation methods were applied for various durations in field studies to examine the efficiency of removing HCHO, TVOC, bacteria, and fungi. The removal efficiency of air pollutants (HCHO and bacteria) through long-term exposure to UVGI appears to increase with time. The effects on TVOC and fungi concentration were insignificant in the first week; however, improvements were observed in the second week. No differences were observed regarding the removal of HCHO and TVOC among the various irradiation methods in this study; however significant differences were observed in the removal of bacteria and fungi.