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. 2000 Aug;90(8):1277–1281. doi: 10.2105/ajph.90.8.1277

Socioeconomic status and multiple myeloma among US blacks and whites.

D Baris 1, L M Brown 1, D T Silverman 1, R Hayes 1, R N Hoover 1, G M Swanson 1, M Dosemeci 1, A G Schwartz 1, J M Liff 1, J B Schoenberg 1, L M Pottern 1, J Lubin 1, R S Greenberg 1, J F Fraumeni Jr 1
PMCID: PMC1446323  PMID: 10937009

Abstract

OBJECTIVES: This study examined the relation between socioeconomic status (SES) and risk of multiple myeloma among Blacks and Whites in the United States. METHODS: This population-based case-control study included 573 cases (206 Blacks and 367 Whites) with new diagnoses of multiple myeloma identified between August 1, 1986, and April 30, 1989, and 2131 controls (967 Blacks and 1164 Whites) from 3 US geographic areas. Information on occupation, income, and education was obtained by personal interview. RESULTS: Inverse gradients in risk were associated with occupation-based SES, income, and education. Risks were significantly elevated for subjects in the lowest categories of occupation-based SES (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.16, 2.53), education (OR = 1.36, 95% CI = 1.06, 1.75), and income (OR = 1.43, 95% CI = 1.05, 1.93). Occupation-based low SES accounted for 37% of multiple myeloma in Blacks and 17% in Whites, as well as 49% of the excess incidence in Blacks. Low education and low income accounted for 17% and 28% of the excess incidence in Blacks, respectively. CONCLUSIONS: Our results indicate that the measured SES-related factors account for a substantial amount of the Black-White differential in multiple myeloma incidence.

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Selected References

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  1. Benichou J., Gail M. H. Variance calculations and confidence intervals for estimates of the attributable risk based on logistic models. Biometrics. 1990 Dec;46(4):991–1003. [PubMed] [Google Scholar]
  2. Berenson J. R., Vescio R. A., Said J. Multiple myeloma: the cells of origin--a two-way street. Leukemia. 1998 Feb;12(2):121–127. doi: 10.1038/sj.leu.2400947. [DOI] [PubMed] [Google Scholar]
  3. Bergsagel D. The incidence and epidemiology of plasma cell neoplasms. Stem Cells. 1995 Aug;13 (Suppl 2):1–9. [PubMed] [Google Scholar]
  4. Bhatia K. G., Cherney B. W., Huppi K., Magrath I. T., Cossman J., Sausville E., Barriga F., Johnson B., Gause B., Bonney G. A deletion linked to a poly(ADP-ribose) polymerase gene on chromosome 13q33-qter occurs frequently in the normal black population as well as in multiple tumor DNA. Cancer Res. 1990 Sep 1;50(17):5406–5413. [PubMed] [Google Scholar]
  5. Blattner W. A., Blair A., Mason T. J. Multiple myeloma in the United States, 1950--1975. Cancer. 1981 Dec 1;48(11):2547–2554. doi: 10.1002/1097-0142(19811201)48:11<2547::aid-cncr2820481134>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  6. Boffetta P., Stellman S. D., Garfinkel L. A case-control study of multiple myeloma nested in the American Cancer Society prospective study. Int J Cancer. 1989 Apr 15;43(4):554–559. doi: 10.1002/ijc.2910430404. [DOI] [PubMed] [Google Scholar]
  7. Brown L. M., Burmeister L. F., Everett G. D., Blair A. Pesticide exposures and multiple myeloma in Iowa men. Cancer Causes Control. 1993 Mar;4(2):153–156. doi: 10.1007/BF00053156. [DOI] [PubMed] [Google Scholar]
  8. Brown L. M., Linet M. S., Greenberg R. S., Silverman D. T., Hayes R. B., Swanson G. M., Schwartz A. G., Schoenberg J. B., Pottern L. M., Fraumeni J. F., Jr Multiple myeloma and family history of cancer among blacks and whites in the U.S. Cancer. 1999 Jun 1;85(11):2385–2390. [PubMed] [Google Scholar]
  9. Brown L. M., Pottern L. M., Silverman D. T., Schoenberg J. B., Schwartz A. G., Greenberg R. S., Hayes R. B., Liff J. M., Swanson G. M., Hoover R. Multiple myeloma among Blacks and Whites in the United States: role of cigarettes and alcoholic beverages. Cancer Causes Control. 1997 Jul;8(4):610–614. doi: 10.1023/a:1018498414298. [DOI] [PubMed] [Google Scholar]
  10. Brown L. M., Silverman D. T., Pottern L. M., Schoenberg J. B., Greenberg R. S., Swanson G. M., Liff J. M., Schwartz A. G., Hayes R. B., Blot W. J. Adenocarcinoma of the esophagus and esophagogastric junction in white men in the United States: alcohol, tobacco, and socioeconomic factors. Cancer Causes Control. 1994 Jul;5(4):333–340. doi: 10.1007/BF01804984. [DOI] [PubMed] [Google Scholar]
  11. Bruzzi P., Green S. B., Byar D. P., Brinton L. A., Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol. 1985 Nov;122(5):904–914. doi: 10.1093/oxfordjournals.aje.a114174. [DOI] [PubMed] [Google Scholar]
  12. Cao J., Hong C. H., Rosen L., Vescio R. A., Smulson M., Lichtenstein A. K., Berenson J. R. Deletion of genetic material from a poly(ADP-ribose) polymerase-like gene on chromosome 13 occurs frequently in patients with monoclonal gammopathies. Cancer Epidemiol Biomarkers Prev. 1995 Oct-Nov;4(7):759–763. [PubMed] [Google Scholar]
  13. Cohen H. J., Crawford J., Rao M. K., Pieper C. F., Currie M. S. Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly. Am J Med. 1998 May;104(5):439–444. doi: 10.1016/s0002-9343(98)00080-1. [DOI] [PubMed] [Google Scholar]
  14. Demers P. A., Vaughan T. L., Koepsell T. D., Lyon J. L., Swanson G. M., Greenberg R. S., Weiss N. S. A case-control study of multiple myeloma and occupation. Am J Ind Med. 1993 Apr;23(4):629–639. doi: 10.1002/ajim.4700230410. [DOI] [PubMed] [Google Scholar]
  15. Dosemeci M., Hayes R. B., Vetter R., Hoover R. N., Tucker M., Engin K., Unsal M., Blair A. Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control. 1993 Jul;4(4):313–321. doi: 10.1007/BF00051333. [DOI] [PubMed] [Google Scholar]
  16. Friedman G. D., Herrinton L. J. Obesity and multiple myeloma. Cancer Causes Control. 1994 Sep;5(5):479–483. doi: 10.1007/BF01694762. [DOI] [PubMed] [Google Scholar]
  17. Goedert J. J., Coté T. R., Virgo P., Scoppa S. M., Kingma D. W., Gail M. H., Jaffe E. S., Biggar R. J. Spectrum of AIDS-associated malignant disorders. Lancet. 1998 Jun 20;351(9119):1833–1839. doi: 10.1016/s0140-6736(97)09028-4. [DOI] [PubMed] [Google Scholar]
  18. Gorey K. M., Vena J. E. Cancer differentials among US blacks and whites: quantitative estimates of socioeconomic-related risks. J Natl Med Assoc. 1994 Mar;86(3):209–215. [PMC free article] [PubMed] [Google Scholar]
  19. Heineman E. F., Olsen J. H., Pottern L. M., Gomez M., Raffn E., Blair A. Occupational risk factors for multiple myeloma among Danish men. Cancer Causes Control. 1992 Nov;3(6):555–568. doi: 10.1007/BF00052753. [DOI] [PubMed] [Google Scholar]
  20. Johnston J. M., Grufferman S., Bourguet C. C., Delzell E., Delong E. R., Cohen H. J. Socioeconomic status and risk of multiple myeloma. J Epidemiol Community Health. 1985 Jun;39(2):175–178. doi: 10.1136/jech.39.2.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Khuder S. A., Mutgi A. B. Meta-analyses of multiple myeloma and farming. Am J Ind Med. 1997 Nov;32(5):510–516. doi: 10.1002/(sici)1097-0274(199711)32:5<510::aid-ajim11>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  22. Koessel S. L., Theis M. K., Vaughan T. L., Koepsell T. D., Weiss N. S., Greenberg R. S., Swanson G. M. Socioeconomic status and the incidence of multiple myeloma. Epidemiology. 1996 Jan;7(1):4–8. doi: 10.1097/00001648-199601000-00002. [DOI] [PubMed] [Google Scholar]
  23. Lewis D. R., Pottern L. M., Brown L. M., Silverman D. T., Hayes R. B., Schoenberg J. B., Greenberg R. S., Swanson G. M., Schwartz A. G., Liff J. M. Multiple myeloma among blacks and whites in the United States: the role of chronic antigenic stimulation. Cancer Causes Control. 1994 Nov;5(6):529–539. doi: 10.1007/BF01831381. [DOI] [PubMed] [Google Scholar]
  24. MacKenzie J., Sheldon J., Morgan G., Cook G., Schulz T. F., Jarrett R. F. HHV-8 and multiple myeloma in the UK. Lancet. 1997 Oct 18;350(9085):1144–1145. doi: 10.1016/s0140-6736(05)63792-0. [DOI] [PubMed] [Google Scholar]
  25. Marcelin A. G., Dupin N., Bouscary D., Bossi P., Cacoub P., Ravaud P., Calvez V. HHV-8 and multiple myeloma in France. Lancet. 1997 Oct 18;350(9085):1144–1144. doi: 10.1016/S0140-6736(05)63791-9. [DOI] [PubMed] [Google Scholar]
  26. McWhorter W. P., Schatzkin A. G., Horm J. W., Brown C. C. Contribution of socioeconomic status to black/white differences in cancer incidence. Cancer. 1989 Mar 1;63(5):982–987. doi: 10.1002/1097-0142(19890301)63:5<982::aid-cncr2820630533>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  27. Nandakumar A., Armstrong B. K., de Klerk N. H. Multiple myeloma in Western Australia: a case-control study in relation to occupation, father's occupation, socioeconomic status and country of birth. Int J Cancer. 1986 Feb 15;37(2):223–226. doi: 10.1002/ijc.2910370209. [DOI] [PubMed] [Google Scholar]
  28. Pasqualetti P., Casale R., Collacciani A., Colantonio D. Attività lavorativa e rischio di mieloma multiplo. Uno studio caso-controllo. Med Lav. 1990 Jul-Aug;81(4):308–319. [PubMed] [Google Scholar]
  29. Pasqualetti P., Colantonio D., Collacciani A., Casale R. Stato socioeconomico e sopravvivenza nel mieloma multiplo. Minerva Med. 1990 Oct;81(10):713–716. [PubMed] [Google Scholar]
  30. Pasqualetti P., Festuccia V., Collacciani A., Casale R. The natural history of monoclonal gammopathy of undetermined significance. A 5- to 20-year follow-up of 263 cases. Acta Haematol. 1997;97(3):174–179. doi: 10.1159/000203676. [DOI] [PubMed] [Google Scholar]
  31. Pottern L. M., Gart J. J., Nam J. M., Dunston G., Wilson J., Greenberg R., Schoenberg J., Swanson G. M., Liff J., Schwartz A. G. HLA and multiple myeloma among black and white men: evidence of a genetic association. Cancer Epidemiol Biomarkers Prev. 1992 Mar-Apr;1(3):177–182. [PubMed] [Google Scholar]
  32. Pottern L. M., Heineman E. F., Olsen J. H., Raffn E., Blair A. Multiple myeloma among Danish women: employment history and workplace exposures. Cancer Causes Control. 1992 Sep;3(5):427–432. doi: 10.1007/BF00051355. [DOI] [PubMed] [Google Scholar]
  33. Rettig M. B., Ma H. J., Vescio R. A., Põld M., Schiller G., Belson D., Savage A., Nishikubo C., Wu C., Fraser J. Kaposi's sarcoma-associated herpesvirus infection of bone marrow dendritic cells from multiple myeloma patients. Science. 1997 Jun 20;276(5320):1851–1854. doi: 10.1126/science.276.5320.1851. [DOI] [PubMed] [Google Scholar]
  34. Szekely L., Klein G. Multiple myeloma and Kaposi's sarcoma-associated herpesvirus--a paracrine model of tumorigenesis? Trends Microbiol. 1997 Nov;5(11):424–426. doi: 10.1016/S0966-842X(97)01152-9. [DOI] [PubMed] [Google Scholar]
  35. Velez R., Beral V., Cuzick J. Increasing trends of multiple myeloma mortality in England and Wales; 1950-79: are the changes real? J Natl Cancer Inst. 1982 Aug;69(2):387–392. [PubMed] [Google Scholar]
  36. Vuckovic J., Ilic A., Knezevic N., Marinkovic M., Zemunik T., Dubravcic M. Prognosis in monoclonal gammopathy of undetermined significance. Br J Haematol. 1997 Jun;97(3):649–651. doi: 10.1046/j.1365-2141.1997.1072923.x. [DOI] [PubMed] [Google Scholar]
  37. Vågerö D., Persson G. Occurrence of cancer in socioeconomic groups in Sweden. An analysis based on the Swedish Cancer Environment Registry. Scand J Soc Med. 1986;14(3):151–160. doi: 10.1177/140349488601400308. [DOI] [PubMed] [Google Scholar]
  38. Williams R. R., Horm J. W. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977 Mar;58(3):525–547. doi: 10.1093/jnci/58.3.525. [DOI] [PubMed] [Google Scholar]

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