Abstract
Myeloproliferative neoplasms (MPNs) are an uncommon group of blood cancers that, if untreated, result in an increased risk of haemorrhagic event or thrombosis. Unlike other cancer types, diagnosis of MPNs requires a combination of microscopic, clinical and genetic evidence, which provide unique
challenges given the typical notification processes of cancer registries. This, and the relatively recent advances in diagnosis and revision of the World Health Organisation diagnostic criteria, may result in under-diagnosis or under-reporting of MPNs.
We used population-based cancer registry data from the Australian Cancer Database and modelled the incidence and survival of MPNs between 2007 and 2016 using generalised linear models and Bayesian spatial Leroux models.
Substantial evidence was found of spatial heterogeneity in the incidence of MPNs and significant differences in incidence and survival by state or territory. States with lower incidence tended to have poorer survival, suggesting that some less severe cases may not be diagnosed or notified to the registries in those states. Population rates of genetic testing and percentages of records diagnosed using bone marrow biopsies did not explain the differences in incidence by state and territory. It is important to determine the key drivers of these geographical patterns, including the need to standardise diagnosis and reporting of MPNs.
challenges given the typical notification processes of cancer registries. This, and the relatively recent advances in diagnosis and revision of the World Health Organisation diagnostic criteria, may result in under-diagnosis or under-reporting of MPNs.
We used population-based cancer registry data from the Australian Cancer Database and modelled the incidence and survival of MPNs between 2007 and 2016 using generalised linear models and Bayesian spatial Leroux models.
Substantial evidence was found of spatial heterogeneity in the incidence of MPNs and significant differences in incidence and survival by state or territory. States with lower incidence tended to have poorer survival, suggesting that some less severe cases may not be diagnosed or notified to the registries in those states. Population rates of genetic testing and percentages of records diagnosed using bone marrow biopsies did not explain the differences in incidence by state and territory. It is important to determine the key drivers of these geographical patterns, including the need to standardise diagnosis and reporting of MPNs.
| Original language | English |
|---|---|
| Pages (from-to) | 328-335 |
| Number of pages | 8 |
| Journal | Pathology |
| Volume | 54 |
| Issue number | 3 |
| Early online date | 29 Mar 2022 |
| DOIs | |
| Publication status | Published - Apr 2022 |
Bibliographical note
Acknowledgments:The authors wish to thank the MPN Alliance Australia for motivating this study and financial support. We would also like to thank the reviewers for their helpful comments.Funding: was provided by the MPN Alliance Australia. The MPN Alliance Australia did not play any role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
Data Availability Statement
Supplementary data to this article can be found online athttps://doi.org/10.1016/j.pathol.2021.06.122
Keywords
- Myeloproliferative neoplasms
- cancer
- incident
- survival
- diagnosis
- registries
- pathology
- health geography
- geographical disparities
- spatial modelling
- statistical modelling
Access to Document
- Cameroin_etal_spatial_disparities_in_AAM
This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/