Multiple myeloma in Korea: past, present, and future perspectives. Experience of the Korean Multiple Myeloma Working Party

Excerpt

The incidence of multiple myeloma suggests an ethnic difference. Compared to Caucasians, who have an incidence rate of 3–5/100,000, Asians show much lower incidence rate compared to them, in the range of 0.5–3/100,000. In Korea, The very first case report of multiple myeloma was published in 1959 [1], and was followed by a few case reports until the 1970s. Since that time, the number of cases of multiple myeloma in Korea increased steadily, reaching 100 cases/year in 1990 [2] and 500 cases/year in 2000 [3], and it is still going up. Currently in Korea, 1,000 patients are estimated to be diagnosed with multiple myeloma, and 700 patients are assumed to die of this disease every year, and 4,000–5,000 patients are suffering from this disease [4]. The most updated, age-standardized, incidence rate of multiple myeloma in Korea is 1.4/100,000, and ranked as the third most common among the hematologic malignancies, only surpassed by non-Hodgkin’s lymphoma and acute myeloid leukemia [5]. Besides, the mortality from multiple myeloma has remarkably increased compared with the mortalities from the other hematologic malignancies, such as leukemia and lymphoma. Indeed, the incidence and mortality of multiple myeloma in Korea have increased more than 30 times during past 30 years [5] (Fig. 1). This unprecedented phenomenon could be explained in two ways. The first one is an increased detection. Expanding medical insurance coverage increased routine checks, and increased awareness of this disease could partly explain in the increased detection, especially in early period of 1980s. The second explanation is a true increase in the incidence of multiple myeloma. Air pollution, and increased exposure to potential carcinogens and radiation are all associated with rapid industrialization, and are suspected as reasons for the increased incidence of multiple myeloma. Another possible reason for the increase is the aging of the Korean population. Koreans have experienced a 17-year median life span over the past 33 years. Since the year of 2,000, Koreans entered an aging society and are heading to an aged society in the year 2020. Moreover, the speed of aging in Korea is known to be fastest in the world. Thus, in the future, we expect more increasing aged population and the incidence of multiple myeloma, considering Japanese model [5]. The median age of the patients with multiple myeloma also increased from mid-fifties in 1980s to 66 years in 2007 [3].

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