Trends of incidence, mortality, and survival of multiple myeloma in Switzerland between 1994 and 2013

Background: Treatment of multiple myeloma has changed considerably over the last two decades with remarkable reduction in mortality rates in clinical trials and in population-based studies. Since health care systems and patient management differ between countries, population-based data from cancer registries with high coverage may provide further insight into real-life achievements and unmet needs. We report on the first population-based nation-wide study of incidence, mortality and survival of multiple myeloma in Switzerland covering the era of autologous stem cell transplantation and the first proteasome inhibitors and immunomodulatory drugs. Methods: We performed a retrospective registry study with data from the National Institute for Cancer Epidemiology and Registration (NICER) database in Switzerland from 1994 to 2013. Results: We identified 5770 patients with multiple myeloma. Incidence has increased from 419 new cases per year in 1994-1998 to 557 new cases per year in 2009-2013 while the age-adjusted incidence rate remained stable at 4.7-5.0 per 100' 000 person-years. Five-and 10-year relative survival increased from 32.6% (95% CI 29.3-36.0) and 17.8% (95% CI 14.9-21.0) in 1994-1998 to 46.4% (95% CI 43.3-49.3) and 25.0% (95% CI 21.9-28.3) in 2009-2013. Conclusion: The increase in incidence can be attributed to demographic changes. There is a trend to longer relative survival in all age groups with substantial increase in myeloma patients aged less than 75 years and only minimal changes in older persons.