Screening for Multiple Myeloma Precursor Could Cut Deaths from the Cancer, Study Finds

Screening people with a family history of a multiple myeloma precursor would significantly reduce the chance that a person would develop and die of the cancer, a study reports.

Scientists call the precursor monoclonal gammopathy of undetermined significance, or MGUS. Its hallmark is an abnormal protein — known as monoclonal protein or M protein — in the blood.

Those with a family history of MGUS are at the highest risk of developing multiple myeloma.

The study, “Computational Model of Progression to Multiple Myeloma Identifies Optimum Screening Strategies,” appeared in the journal JCO|Clinical Cancer Informatics.

MGUS usually causes no problems. But it can develop over a number of years into other disorders, including blood cancers like myeloma. Almost all myeloma patients develop MGUS first.

About 2 percent of people over 50 years old have the precursor, which is more common in men. It is also a little more common in African-Americans than others.

Researchers used a computer to study the relationship between the incidence of MGUS and its progression to multiple myeloma. Then they translated the information into a recommended screening regime for MGUS.

They said starting to screen for MGUS at age 55 in high-risk individuals and doing follow-up screening every six years would reduce the number of multiple myeloma cases by 19 percent. The same drop in multiple myeloma cases would result from starting screening at age 65 and doing follow-up screening every two years. The screening could reduce multiple myeloma deaths 40 percent, they said.

The team said patients diagnosed with MGUS could prevent progression to multiple myeloma by taking medication such as aspirin or metformin, or improving their lifestyle with exercise and changes in diet.

If doctors screened people at high risk of developing multiple myeloma for MGUS, a lot fewer would develop the cancer, they said. They added that additional research would need to be done to confirm the screening’s effectiveness.

“The goals of screening are to detect MGUS early and reduce MM [multiple myeloma] prevalence and mortality as a result of mild interventions leading to an MGUS to MM [multiple myeloma] progression risk reduction,” the researchers wrote.

“Screening efforts should focus on specifically identified groups with high lifetime risk of MGUS, for which screening benefits can be significant. Screening low-risk individuals with MGUS would require improved preventions,” they concluded.