Socioeconomic status and multiple myeloma among US Blacks and Whites

Objective. This study examined the relation between socioeconomic status (SES) and risk of multiple myeloma among Blacks and Whites in the United States. Methods. This population-based case-control study included 573 cases (206 Blacks and 367 Whites) with new diagnoses of multiple myeloma identified between August 1, 1986, and April 30, 1989, and 2131 controls (967 Blacks and 1164 Whites) from 3 US geographic areas. Information on occupation, income, and education was obtained by personal interview. Results. Inverse gradients in risk were associated with occupation-based SES, income, and education. Risks were significantly elevated of subjects in the lowest categories of occupation-based SES (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.16, 2.53), education (OR = 1.36, 95% CI = 1.06, 1.75), and income (OR = 1.43, 95% CI = 1.05, 1.93). Occupation-based low SES accounted for 37% of multiple myeloma in Blacks and 17% in Whites, as well as 49% of the excess incidence in Blacks Low education and low income accounted for 17% and 28% of the excess incidence in Blacks, respectively. Conclusions. Our results indicate that the measured SES-related factors account for a substantial amount of the black-White differential in multiple myeloma incidence.