Black Americans have a higher likelihood of multiple myeloma than white Americans but face disparities in treatment.

Various factors may contribute to why multiple myeloma disproportionally affects Black Americans. These include inequities in access to care, clinical trials, and new treatments, as well as a higher likelihood of certain health conditions.

This article explores these factors, investigating rates of multiple myeloma in Black Americans, the healthcare disparities, multiple myeloma symptoms, and more.

A Black woman who may have multiple myeloma sitting in a chair -2.Share on Pinterest
Maskot/Getty Images

Multiple myeloma disproportionally affects Black Americans.

A 2022 study notes that earlier data estimates there would be 15.8 new cases of multiple myeloma in Black Americans per 100,000 people in 2019 compared with 6.9 new cases in white people.

2020 research found that doctors diagnose twice as many Black Americans with multiple myeloma as white Americans.

According to the National Cancer Institute, Black Americans are also more likely than white Americans to receive a multiple myeloma diagnosis at an earlier age: On average, doctors diagnose multiple myeloma in Black Americans at age 66 years and in white Americans at age 70.

Researchers have identified some factors that may play a role in the higher rates of multiple myeloma in Black Americans.

For example, Black Americans may be more likely to inherit monoclonal gammopathy of undetermined significance (MGUS).

MGUS is a plasma cell disorder that sometimes precedes multiple myeloma. The rate of MGUS is three times higher in Black Americans than it is in white Americans.

Because MGUS may increase the risk of multiple myeloma, it may play a role in higher rates of multiple myeloma in Black Americans. However, not everyone with MGUS will develop multiple myeloma.

Black people may also be more likely to have immunoglobulin A disease, which may increase the risk of multiple myeloma.

More research and greater inclusion of Black Americans in clinical trials are necessary to determine the extent of the roles these factors may play in multiple myeloma.

Sometimes multiple myeloma does not cause symptoms.

General symptoms of multiple myeloma might include:

Black people generally experience typical symptoms, although multiple myeloma tends to develop at an earlier age in Black people than in white people.

Black people may also be more likely to develop a complication of multiple myeloma called hypercalcemia, which is excess calcium in the blood. Hypercalcemia can cause:

Due to systemic and structural racism in the United States, Black Americans face various barriers to adequate, affordable healthcare, which can affect the level of medical attention they receive.

For instance, Black Americans have a higher risk of health conditions that can increase the risk of multiple myeloma, such as obesity and diabetes. Inadequate access to care to manage these comorbid conditions may lead to higher rates of multiple myeloma in Black Americans.

Inadequate access to care may also contribute to higher rates of death from multiple myeloma in Black Americans.

Racial disparities in multiple myeloma treatment include:

  • Access to affordable healthcare: A 2021 study found that due to a combined effect of income and race on insurance coverage, people with poor health in low income, marginalized communities had 68% lower odds of having health insurance than people with good health in high income, white communities.
  • Delayed diagnosis and treatment: Black Americans are more likely to receive a diagnosis of multiple myeloma at a later stage than white Americans. A 2019 study found that after diagnosis, the average length of time until starting treatment with an emerging, novel therapy was 5.2 months for Black people and 2.7 months for white people.
  • Differential treatment: The National Cancer Institute cites a 2013 study that found that even with health insurance, non-white people were significantly less likely to receive treatment with transplants or novel agents for multiple myeloma.

Despite higher rates of multiple myeloma in Black Americans, the population is severely underrepresented in clinical trials.

Research from 2023 shows that of the 2,896 participants researchers included in multiple myeloma clinical trials over more than 2 decades, only 18% were non-white.

In important clinical trials leading to U.S. regulatory approval of multiple myeloma drugs, only 4.5% of trial participants were Black Americans.

To address disparities in the research and treatment of multiple myeloma, organizations and researchers can:

  • Increase awareness: Organizations such as the Multiple Myeloma Research Foundation are working to increase awareness and provide education and healthcare access to marginalized communities.
  • Provide financial assistance: Financial stability is a major barrier to adequate healthcare for many Black Americans. Cancer Care provides information on sources of financial assistance for people with cancer.
  • Increase Black American participation in clinical trials: Researchers can work to include more Black Americans in clinical trials. Doing so can help them better understand why multiple myeloma disproportionally affects Black people and find the most effective treatments for Black people.

About twice as many Black Americans develop multiple myeloma than white Americans.

Certain other health conditions may play a role, such as a higher likelihood of a precursor to multiple myeloma called MGUS in Black Americans.

Disparities in the treatment of Black Americans due to reduced access to healthcare, underrepresentation in clinical trials, and delays to diagnosis and treatment may also lead to a higher rate of death from multiple myeloma in Black Americans.