Multiple myeloma in South Africa: Is the incidence increasing?
The original publication is available at http://www.samj.org.za
Multiple myeloma was once thought to be extremely rare, with an estimated frequency of less than 0.1% of all malignant tumours. In 1964 Oettle reported that available mortality statistics showed 171 deaths in the 10-year period 1949-1958 in the RSA for Whites, Coloureds and Asiatics aged 20 years and older. During the 5-year period 1968-1972 however, 222 cases of multiple myeloma appeared in the mortality records of the Central Statistical Service. Since 1964 150 new cases have been diagnosed at Karl Bremer Hospital and later at Tygerberg Hospital, with an average of 15 new cases per year from 1978 to 1982. Four examples of familial myelomatosis and one of familial macroglobulinaemia were found at these two hospitals. On 1 January 1983, 48 patients were on record who had attended the Tygerberg Hospital Haematology Clinic and 78 who had attended Groote Schuur Hospital, giving a total of 126 patients under treatment in the Western Cape during 1982. In addition, for the 6-year period from January 1971 to December 1976, 162 patients were reported from the haematology clinics at the Johannesburg General Hospital and Baragwanath Hospital. The true incidence of multiple myeloma in the RSA is problematical because there is no National Cancer Register; establishment of such a register would need the co-operation of all doctors in the country.
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