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Time to Multiple Myeloma Diagnosis Could Be Cut Significantly


July 13, 2018

A recent study published in BMJ Open found that the current time to diagnosis of more than 3 months for multiple myeloma could be significantly reduced.

The researchers explained that due to a complicated symptom profile, the current time to diagnosis for multiple myeloma is higher than most other cancers.

“Half of patients with symptomatic myeloma have three or more consultations in primary care before they are referred to specialist care, which is more than in any other cancer,” Constantinos Koshiaris, BSc, MSc, of the Department of Primary Care Health Sciences at the University of Oxford in the United Kingdom, and colleagues wrote. “Attributing symptoms to comorbidities further prolongs the diagnostic process, which is particularly relevant in this older age group.”

They further explained that this delay can lead to significant medical issues which can further delay proper diagnosis and treatment initiation due to the need to mitigate these critical adverse events.

“Delays in diagnosing myeloma allow complications to develop (end organ damage), such as pathological fractures, irreversible renal failure and in some cases spinal cord compression,” Dr Koshiaris and colleagues wrote. “These are considered medical emergencies in their own right and limit the opportunity for initiating effective treatment. A delayed diagnosis is also linked with higher cancer stage, which is in turn associated with poorer survival.”

In order to better understand the duration of each step of the multiple myeloma diagnosis pathway, the researchers conducted a meta-analysis of nine studies that “reported time intervals from onset of symptoms to diagnosis.”

Study results showed that the average multiple myeloma patient waits 1 month before seeking help for symptoms, with a quarter of patients waiting about 98 days. The researchers determined that after seeking help from primary care for symptoms, the average time to diagnosis is 108.6 days.

Additionally, the researchers highlighted that 25% of patients waited longer than 8 months before receiving a multiple myeloma diagnosis.

“There is potential for meaningful reductions in the time to diagnosis especially for the diagnostic interval, which could improve patient outcomes, but more research is required in order to do that,” the researchers concluded. “Further and more in-depth exploration of the diagnostic pathway is required especially for the intervals we were not able to explore in this study like the referral to diagnosis interval and its link with the primary care interval. Development of interventions that aim to reduce the length of the diagnostic interval are now needed.”

David Costill


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