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Abstract
Multiple myeloma is a hematologic neoplasm with a unique and characteristic manifestation. This condition is responsible for 10% of hematologic malignancies, and thus represents 1% of all cases of cancer in the US. In Korea, unlike in Western society, myeloma has classically been relatively rare, due in part to racial differences. However, the incidence of this disease in Korea has increased steadily over the last 25 years. During this period, both the incidence of and mortality due to myeloma increased by up to 30-fold. Currently, incidence rate and mortality rate exceed 1.0/100,000. Possible reasons for this increase include better detection, as well as an actual increase, probably attributable to contributing factors, including pollution, exposure to chemicals, and socioeconomic change, all of which are related to rapid industrialization. Aging is another important factor contributing to this perceived increase. With the advent of targeted therapy, Korean myeloma study group was organized under the auspice of Korean society of hematology. In addition, Korean myeloma registry was established recently. In this study, epidemiological changes in the incidence and mortality of multiple myeloma in Korea are assessed and compared with the situations of the US and Japan. This article also claims the need for multicenter clinical trials as well as activation of basic researches in myeloma.
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 | Fig. 1The relative incidence of myeloma among the hematologic malignancies (myeloproliferative diseases and myelodyspla-stic syndromes are excluded). In US (A), multiple myeloma is the second common hematologic malignancy, which proportion was 14% in SEER (1998～2002). In Korea (B), the proportion of myeloma was 10%, ranked as 4th in national cancer registry (2002). |
 | Fig. 2The changes in incidence of multiple myeloma in Korea during the past 22 years. The red bars indicate the incidence between 1981 and 1990 according to the retrospective data of Yang et al.8) The blue bars indicate the incidence from 1998 till 2002 in national cancer registry. The pink bars represent the incidence of myeloma during 3 years (1999~2001) according to the report of Korean Ministry of Health and Welfare. |
 | Fig. 3The incidence change of total cancer in Korea during the past 22 years. The black bars indicate the incidence from 1998 till 2002 in national cancer registry. The pink bars represent the incidence of myeloma during 3 years (1999~2001) according to the report of Korean Ministry of Health and Welfare. |
 | Fig. 4Recent prevalence of multiple myeloma in Korea. Data from Korean Health Insurance Review Agency (2001～ 2004). |
 | Fig. 6Changes in mortality cases from total cancer, multiple myeloma (MM), non-Hodgkin's lymphoma (NHL) and leukemia during the last 20 years from the data of Korean National Statistics Office. |
 | Fig. 7Comparison of fatality rate among hematologic malignancy. Despite of recent progress, multiple myeloma still remains as an incurable disease. |
 | Fig. 8Changes of incidence and mortality of multiple myeloma in Korea during recent 25 years. |
Table 1.
Comparison of epidemiological parameters in Korea, Japan, and US
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