Prior cancer and risk of monoclonal gammopathy of undetermined significance - a population-based study in Iceland and Sweden

Sep 21, 2026

Uploaded by Aria

Evidence suggests prior cancer may increase the risk of developing multiple myeloma (MM), implying that people with past malignancy could show higher MGUS prevalence or faster progression to MM and related plasma-cell disorders. This two-part population study evaluated MGUS status at screening in the iStopMM cohort and assessed MGUS progression in a Swedish registry cohort. Results showed only a modest, time-limited MGUS excess risk and no significant etiologic role for prior cancer.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Introduction

Rationale and background

Study motivation and objectives

ARTICLE-Plasma Cell Disorders Prior cancer and risk of monoclonalgammopathy of undetermined significance: a population-based study in Iceland and Sweden Sæmundur Rögnvaldsson,1,2 Sigrun Thorsteinsdóttir,1,3 Elisavet Syriopoulou,4,5 Ingigerdur Sverrisdottir,1,6 Ingemar Turesson,7 Elias Eythorsson,1,2 Jon Thorir Oskarsson,1 Thorir Einarsson Long,1,7 Brynjar Vidarsson,2 Pall Torfi Onundarson,1,2 Bjarni A. Agnarsson,1,2 Margret Sigurdardottir,2 Isleifur Olafsson,2 Ingunn Thorsteinsdottir,2 Thor Aspelund,1 Gauti Kjartan Gislason,1 Andri Olafsson,1 Jon Kristinn Sigurdsson,1 Malin Hultcrantz,8 Brian G. M. Durie,9 Stephen Harding,10 Magnus Bjorkholm,4,11 Ola Landgren,12 Thorvardur Jon Love1,2 and Sigurdur Yngvi Kristinsson1,2 1 Faculty of Medicine, University of Iceland, Reykjavík, Iceland; 2 Landspítali – The National University Hospital of Iceland, Reykjavík, Iceland; 3 Rigshospitalet, Copenhagen, Denmark; 4 Karolinska Institutet, Stockholm, Sweden; 5 Red Door Analytics AB, Stockholm, Sweden; 6Sahlgrenska University Hospital, Gothenburg, Sweden; 7Skåne University Hospital, Lund, Sweden; 8 Myeloma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; 9Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA, USA; 10 Binding Site Group Ltd., Birmingham, UK; 11 Karolinska University Hospital, Stockholm, Sweden and 12 Myeloma Program, Department of Medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, USA Abstract Correspondence: S. Rögnvaldsson [srognvald@hi.is](srognvald@hi.is) Received: September 25, 2023. Accepted: January 4, 2024. Early view: January 11, 2024. [https://doi.org/10.3324/haematol.2023.284365](https://doi.org/10.3324/haematol.2023.284365) ©2024 Ferrata Storti Foundation Published under a CC BY-NC license There is some evidence that a prior cancer is a risk factor for the development of multiple myeloma (MM) . If this is true, prior cancer should be associated with a higher prevalence or increased progression rate of monoclonal gammopathy of undetermined significance (MGUS), the precursor of MM and related disorders. Those with a history of cancer might therefore constitute a target population for MGUS screening. This two-part study is the first study to evaluate a relationship between MGUS and prior cancers. First, we evaluated whether prior cancers were associated with having MGUS at the time of screening in the Iceland Screens Treats or Prevents Multiple Myeloma (iStopMM) study that includes 75,422 individuals screened for MGUS. Next, we evaluated the association of prior cancer and the progression of MGUS to MM and related disorders in a population-based cohort of 13,790 Swedish individuals with MGUS. A history of prior cancer was associated with a modest increase in the risk of MGUS (odds ratio=1 .10; 95% confidence interval: 1.00-1.20) . This excess risk was limited to prior cancers in the year preceding MGUS screening. A history of prior cancer was associated with progression of MGUS, except for myeloid malignancies which were associated with a lower risk of progression (hazard ratio=0.37; 95% confidence interval: 0.16-0.89; P=0.028) . Our findings indicate that a prior cancer is not a significant etiological factor in plasma cell disorders. The findings do not warrant MGUS screening or different management of MGUS in those with a prior cancer. Introduction Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma (MM), Waldenström macroglobulinemia (WM), and other lymphoproliferative disorders (LPD) 1,2 MGUS is common in the general population with a prevalence of 4.2% in subjects over the age of 50 years, but only in 0.5-1.5% per year does the MGUS progress to active malignancy.2-4 The causes of MM, WM and other LPD are poorly understood but both genetic5 and environmental6,7 causes have been implicated. Importantly, b

FAQs

What question does the study investigate about prior cancer and MGUS?

It evaluates whether a history of cancer is associated with having MGUS at screening and with subsequent progression of MGUS to multiple myeloma or related disorders.

How were the data sources structured in this two-part study?

MGUS at screening was assessed in the Iceland Screens Treats or Prevents Multiple Myeloma (iStopMM) study cohort, and progression was evaluated using a large Swedish population-based MGUS registry with long follow-up.

What were the key findings regarding MGUS risk and progression after prior cancer?

Prior cancer was linked to a modest increase in MGUS risk that was limited to cancers occurring in the year before screening. Prior cancer was associated with progression of MGUS overall, except that myeloid malignancies showed a lower progression risk.

Sep 21, 2026

Uploaded by Aria