Incidence of Plasma Cell Myeloma In Ethnic Chinese In British Columbia, a 30-Year Survey From 1975–2004

Abstract Abstract 2956 Introduction: The incidence of plasma cell myeloma (PCM) in East Asian population is known to be 3–4 times lower than that in Caucasians. This may be due to genetic or environmental factors. Migrant studies may separate these factors to some extent by determining whether the disease incidence follows the parent or destination prevalence. British Columbia (BC) has a large population of Chinese migrants and therefore, it is an ideal population for migrant studies. Hong Kong (HK) is chosen as the comparison population because it has meticulous census data and a population-based cancer registry. Methods: Computerized records of all PCM cases diagnosed from 1975 to 2004 were retrieved from the British Columbia Cancer Agency (BCCA) and the Hong Kong Cancer Registry (HKCR). Cases with Chinese ethnicity in BC were identified by surname using a previously validated methodology and verified from electronic charts. Age distribution of HK, BC and BC Chinese populations for consecutive 5-secular year (yr.) periods were obtained from census departments from the respective governments. The crude incidence rates of PCM were calculated and 95% CI were determined using normal approximation of Poisson distribution. Projected PCM incidence rates in BC Chinese using HK and BC models were calculated and standard incidence ratios (SIR) estimated. Results: There was a steady increase in PCM from 1975 to 2004: from 42 to 159 cases/yr. in HK and from 86 to 207 cases/yr. in BC. This is likely due to population growth and aging. The proportion of population with age >65 grew from 5.4% to 11.2% in HK and from 9.7% to 13.2% in BC. From 1975–2004, a total of 106 cases of BC Chinese PCM were identified, increasing from 0.4 to 8 cases/yr. The BC Chinese population grew from 0.07 to 0.37 million, while the elderly subgroup (age >65) grew from 7.9% to 12.9%. Age specific mean 30-year crude incidence/100,000 person-years and 95% CI in the 3 cohorts were determined (Table 1). The standardized incidence ratio (SIR) of PCM in BC Chinese from 1975–2004 was 0.83 (95% CI 0.68–1.00) when compared to HK and 0.44 (0.36-0.53) when compared to the BC population. Cumulative SIRs of PCM in BC Chinese when compared to BC population remained low for incremental 5-year from 1975–2004 (Table 2). Conclusion: The incidence of PCM in ethnic Chinese in British Columbia is lower compared to the Caucasian counterparts, but similar to the incidence seen in HK. The trend is apparent in all age groups over 45 years old. This observation suggests a strong genetic predisposition in the development of PCM. Disclosures: No relevant conflicts of interest to declare.

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Osteoarthritis Incidence and Trends in Administrative Health Records from British Columbia, Canada

The Journal of Rheumatology ◽

10.3899/jrheum.131011 ◽

2014 ◽

Vol 41 (6) ◽

pp. 1147-1154 ◽

Cited By ~ 13

Author(s):

M. Mushfiqur Rahman ◽

Jolanda Cibere ◽

Charlie H. Goldsmith ◽

Aslam H. Anis ◽

Jacek A. Kopec

Keyword(s):

British Columbia ◽

Hospital Admission ◽

Regression Models ◽

Incidence Rates ◽

Crude Incidence Rate ◽

Case Definitions ◽

Health Records ◽

Crude Incidence ◽

Age Adjusted Rates ◽

Physician Diagnosis

Objective.To calculate the incidence rates of osteoarthritis (OA) and to describe the changes in incidence using 18 years of administrative health records.Methods.We analyzed visits to health professionals and hospital admission records in a random sample (n = 640,000) from British Columbia, Canada, from 1991/1992 through 2008/2009. OA was defined in 2 ways: (1) at least 1 physician diagnosis or 1 hospital admission; and (2) at least 2 physician diagnoses in 2 years or 1 hospital admission. Crude and age-standardized rates were calculated, and the annual relative changes were estimated from the Poisson regression models.Results.In 2008/2009, the overall crude incidence rate (95% CI) of OA using definition 1 was 14.6 (14.0–14.8); [12.5 (12.0–13.0) among men and 16.3 (15.8–16.8) among women] per 1000 person-years. The rates were lower by about 44% under definition 2. For the period 2000/2001–2008/2009, crude incidence rates based on definition 1 varied from 11.8 to 14.2 per 1000 person-years for men, and from 15.7 to 18.5 for women. Annually, on average, crude rates rose by about 2.5–3.3% for both men and women. The age-adjusted rates increased by 0.6–0.8% among men and showed no trend among women.Conclusion.Our study generated updated incidence rates of administrative OA for the Province of British Columbia. Physician-diagnosed overall incidence rates of OA varied with the case definitions used; however, trends were similar in both case definitions. Age-adjusted rates among men increased slightly during the period 2000/2001–2008/2009. These findings have implications for projecting future prevalence and costs of OA.

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Increasing Incidence of Chronic Lymphocytic Leukemia in Korea, 1999-2010: Comparison to Plasma Cell Myeloma

Blood ◽

10.1182/blood.v126.23.5277.5277 ◽

2015 ◽

Vol 126 (23) ◽

pp. 5277-5277

Author(s):

Seung Jun Lee ◽

Hwei-Fang Tien ◽

Hyeon Jin Park ◽

Jung-Ah Kim ◽

Dong Soon Lee

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Plasma Cell ◽

Incidence Rates ◽

Pacific Islanders ◽

Lymphocytic Leukemia ◽

Plasma Cell Myeloma ◽

Asian Countries ◽

Asian Pacific Islander ◽

The Us ◽

Asian Pacific

Abstract Introduction: Chronic lymphocytic leukemia (CLL) and plasma cell myeloma (PCM) have markedly higher incidences in Western compared with Asian countries. In Asian countries, both CLL and PCM have increased over the previous few decades. However, the epidemiologic characteristics of CLL have not been previously studied in Korea. To track the changing trends in the incidence of CLL and PCM, we investigated epidemiologic data in Korea from 1999 to 2010 and compared it with data regarding Taiwanese and Caucasian Americans. We specifically addressed the differences in the trends of CLL and PCM. Methods: We included patients diagnosed with CLL or PCM between 1999 and 2010 from the KCCR and between 1992 and 2010 from the SEER database. We utilized the International Classification of Diseases for Oncology 3rd edition (ICD-O-3) codes for CLL (9823/3) and PCM (9732/3). The age at diagnosis was classified into 18 age groups by 5-year intervals. The data of Taiwan was obtained by personal communication. Results: The ASR of CLL from 1999 to 2010 in Korea was 0.13/100,000 person-years (0.17/100,000 for men and 0.09/100,000 for women). The APC in the CLL incidence in Korea was 4.17% (95% CI: 0.77-7.68%) (Table 1). For comparison, the ASR of the CLL in the US from 1999 to 2010 was 3.21/100,000, and CLL exhibited an APC of 0.68% (95% CI: -0.39 to 1.77%). The APC of CLL over the previous 12 years in Korea (4.17%) was markedly higher (i.e., 6.1-fold) compared with the US (0.68%). In a comparison of different ethnic groups, the ASR in Caucasians was 3.57/100,000; this incidence was the highest rate observed (Figure 1). The ASRs in individuals of African descent and Asians/Pacific Islanders were 2.41/100,000 and 0.74/100,000, respectively. The temporal trends in the ASRs in all races remained stable. The ASR of PCM for the period from 1999 to 2010 in Korea was 1.23/100,000 person-years (1.51/100,100 for men and 1.04/100,000 for women). The APC in the PCM incidence rates was 4.68% (95% CI: 4.12-5.24%) (Table 1). The ASR of PCM in the US from 1999 to 2010 was 3.97/100,000, which was 3.2-fold higher compared with Korea. The incidence of PCM in the US increased, with an APC of 0.50% (95% CI: 0.11-0.88%). The APC in Korea during the same period was 9.4-fold higher compared with the US. In the US, differences in the incidence were observed among ethnic groups, including Caucasians, African Americans and Asians or Pacific Islanders (Figure 1). African Americans constituted the group most susceptible to PCM, with an ASR of 8.42/100,000. The ASRs for Caucasian and Asians/Pacific Islanders were 3.67/100,000 and 2.37/100,000, respectively. The ASRs for the all races remained stable. Conclusion: In conclusion, the incidence rates of CLL have gradually increased from 1999 to 2010, while those of PCM have increased steeply. Both of them still show prominent lower incidences compared to US, but the incidence rates of CLL and PCM appears to be stable in the US. Though genetic background is the key factor for ethnic difference in the incidence, further study will be needed to elucidate the reason for recent differential increasing trends between CLL and PCM incidence in Korea. Table 1. Comparison of incidence and trend in CLL and PCM during 1999-2010 between US and Korea °° °° US Korea Comparison (US/Korea) CLL ASR* 3.21 0.13 24.69 APC (95% CI) 0.68 (-0.39 to 1.77) 4.17 (0.77 to 7.68)¢" 0.16 PCM ASR* 3.97 1.23 3.23 °° APC (95% CI) 0.50 (0.11 to 0.88)¢" 4.68 (4.12 to 5.24)¢" 0.11 * ASR are expressed per 100,000 person-years ¢" APC is statistically significantly different from zero Abbreviation: CLL, chronic lymphocytic leukemia; PCM, plasma cell myeloma; ASR, age-standardized rate; APC, annual percentage change; CI, confidence interval. Figure 1. The age-standardized incidence rates of (A) chronic lymphocytic leukemia and (B) plasma cell myeloma in US, Taiwan, and Korea Abbreviation: W, White; B, Black; API, Asian/Pacific Islander. Figure 1. The age-standardized incidence rates of (A) chronic lymphocytic leukemia and (B) plasma cell myeloma in US, Taiwan, and Korea. / Abbreviation: W, White; B, Black; API, Asian/Pacific Islander. Disclosures No relevant conflicts of interest to declare.

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Treatment of plasma cell myeloma with cytotoxic agents

Archives of Internal Medicine ◽

10.1001/archinte.135.1.172 ◽

1975 ◽

Vol 135 (1) ◽

pp. 172-176 ◽

Cited By ~ 4

Author(s):

D. E. Bergsagel

Keyword(s):

Plasma Cell ◽

Cytotoxic Agents ◽

Plasma Cell Myeloma

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Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-048744 ◽

2021 ◽

Vol 11 (5) ◽

pp. e048744

Author(s):

Andreea Bratu ◽

Taylor McLinden ◽

Katherine Kooij ◽

Monica Ye ◽

Jenny Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

British Columbia ◽

Cohort Study ◽

Population Based ◽

Incidence Rates ◽

Trend Test ◽

People Living With Hiv ◽

Age Related ◽

Hiv Serostatus ◽

The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

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Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?

BMC Public Health ◽

10.1186/s12889-021-11089-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Vidya Lakshmi Purushothaman ◽

Raphael E. Cuomo ◽

Cedric F. Garland ◽

Timothy K. Mackey

Keyword(s):

Colorectal Cancer ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Age Groups ◽

Incidence Rates ◽

Ultraviolet B ◽

Inverse Association ◽

Crude Incidence ◽

Age Dependent ◽

Uvb Exposure

Abstract Background Vitamin D has been identified as a potential protective factor in the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition) model postulates various stages of cancer development due to vitamin D deficiency and the associated latency period. The purpose of this study is to examine this age-dependent inverse relationship globally. Methods In this ecological study, a series of linear and polynomial regression tests were performed between country-specific UVB estimates adjusted for cloud cover and crude incidence rates of CRC for different age groups. Multiple linear regression was used to investigate the association between crude incidence rates of colorectal cancer and UVB estimate adjusting for urbanization, skin pigmentation, smoking, animal consumption, per capita GDP, and life expectancy. Statistical analysis was followed by geospatial visualization by producing choropleth maps. Results The inverse relationship between UVB exposure and CRC crude rates was stronger in older age groups at the country level. Quadratic curve fitting was preferred, and these models were statistically significant for all age groups. The inverse association between crude incidence rates of CRC and UVB exposure was statistically significant for age groups above 45 years, after controlling for covariates. Conclusion The age-dependent inverse association between UVB exposure and incidence of colorectal cancer exhibits a greater effect size among older age groups in global analyses. Studying the effect of chronic vitamin D deficiency on colorectal cancer etiology will help in understanding the necessity for population-wide screening programs for vitamin D deficiency, especially in regions with inadequate UVB exposure. Further studies are required to assess the need for adequate public health programs such as selective supplementation and food fortification.

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