Incidence of monoclonal gammopathy of undetermined significance and estimation of duration before first clinical recognition

Terry M. Therneau, Robert A. Kyle, L. Joseph Melton, Dirk R. Larson, Joanne T. Benson, Colin L. Colby, Angela Dispenzieri, Shaji Kumar, Jerry A. Katzmann, James R. Cerhan, S. Vincent Rajkumar

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Abstract

Objectives: To determine the incidence of monoclonal gammopathy of undetermined significance (MGUS) in the general population and to estimate the duration of occult MGUS before first diagnosis. Methods: To estimate incidence we used innovative methods to exploit the Olmsted County, Minnesota, MGUS prevalence data, along with follow-up from a large cohort of patients with clinically detected MGUS. The prevalence cohort consisted of 21,463 persons systematically screened for the presence or absence of MGUS. The clinical cohort consisted of 7472 patients with MGUS diagnosed at Mayo Clinic from January 1, 1990, to May 13, 2010. The incidence of MGUS was estimated using the prevalence estimates, the rate of MGUS progression, and the death rates from MGUS using Markov chain methods. Results: We estimate that the annual incidence of MGUS in men is 120 per 100,000 population at the age of 50 years and increases to 530 per 100,000 population at the age of 90 years. The rates for women are 60 per 100,000 population at the age of 50 years and 370 per 100,000 population at the age of 90 years. We estimate that 56% of women 70 years of age diagnosed as having MGUS have had the condition for more than 10 years, including 28% for more than 20 years. Corresponding values for men are 55% and 31%, respectively. At 60 years of age, the proportion of prevalent cases that are clinically recognized is 13%. This rate increases to 33% at the age of 80 years. Conclusion: In addition to an accumulation of cases, the age-related increase in prevalence of MGUS is related to a true increase in incidence with age. When first clinically recognized, MGUS has likely been present in an undetected state for a median duration of more than 10 years.

Original languageEnglish (US)
Pages (from-to)1071-1079
Number of pages9
JournalMayo Clinic proceedings
Volume87
Issue number11
DOIs
StatePublished - Nov 2012

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ASJC Scopus subject areas

  • Medicine(all)

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