New Study Shows Racial Disparities in Treatment and Survival Among Seniors with Multiple Myeloma

A recent study published in Cancer Medicine highlights the persistence of racial differences in treatment and survival among people ages 66 years and older diagnosed with multiple myeloma (MM).

MM is a hematologic malignancy that primarily affects older adults, with a median age at diagnosis of 69 years. Racial disparities in MM treatment and prognosis have been well-documented, with non-Hispanic African Americans having a higher risk of developing and dying from MM compared to their non-Hispanic White counterparts. African Americans also have a higher incidence and mortality rate from MM compared to other cancers.

The development of new and improved therapeutic agents has improved the treatment outcomes for MM over the past few decades. It remains unclear whether these racial disparities have persisted in the era of novel agents.

To investigate racial differences in treatment utilization and survival among older MM patients, a group of researchers including Rong Wang, Ph.D., senior research scientist in epidemiology at Yale School of Medicine, conducted a database study analyzing records from Medicare beneficiaries aged 66 and older diagnosed with MM between 2007 and 2017.

Of the older folks with MM, 59.5% of African American patients and 64.8% of White patients received treatment in the first year following diagnosis. The analysis showed that the difference in treatment rates between African American and White patients increased over time. In the years 2007 to 2009, the difference was 2.9%, while in the years 2014 to 2017, the difference increased to 6.9%.

The results also showed that African American patients were less likely to receive treatment in the first year after diagnosis compared to White patients but had lower mortality. The lower mortality was only observed among patients who did not receive treatment. African American and White patients who received treatment had similar rates of survival. Initiating treatment earlier was associated with a lower risk of death.

The authors described their findings as consistent with past studies showing that African American patients were less inclined to undergo treatment and were more likely to experience delays in starting treatment.

The researchers wrote the inequality may be exacerbated by the high cost of newer therapies. They stated the Affordable Care Act has not completely resolved these disparities, and further investigation is needed to determine if recent policy changes can help reduce the racial disparity.

“As novel agents are effective but expensive, such inequity may escalate if financial burden is the primary barrier for African American patients with MM to access care," researchers wrote.