from Section 1 - Overview of myeloma
Published online by Cambridge University Press: 18 December 2013
Introduction
Epidemiology is the basic quantitative science of public health; and as such is concerned with the distribution, determinants, treatment, management and potential control of disease. Concentrating on the first two of these, this chapter reviews the epidemiology of myeloma, which accounts for around 1%–2% of all newly diagnosed cancers, and 10%–15% of all newly diagnosed hematological malignancies[1,2].
Descriptive epidemiology
The accurate description of underlying disease patterns and trends provides the foundation for etiological research[3], hence before considering the epidemiology of myeloma in any depth issues relating to disease ascertainment and classification are briefly discussed below.
Cancer ascertainment and classification
Whilst cancer registration has a long history in many countries, particularly those in the more affluent regions of the world, nearly 80% of the global population is not covered by such systems [1]. Furthermore, for hematological cancers, information gathering and dissemination has long been acknowledged to be a major problem even in countries that have adequate collations processes. These concerns were summarized in EUROCARE 4 in their 2009 statement that “the evolving classification and poor standardization of data collection on haematological malignancies vitiate the comparison of disease incidence and survival over time and across regions” [4]. The main issue here is that, unlike many other cancers, the majority of hematological neoplasms are diagnosed by using multiple parameters, including a combination of histology, cytology, immunophenotyping, cytogenetics, imaging and clinical information.
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