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The etiology of Multiple Myeloma is generally acknowledged as obscure.1 The epidemiology presents a number of puzzles. Most cancers are the affliction of age. Myeloma is more remarkably so, with few cases under the age of 40, (0.3% under 30), 98% above this demarcation line and a median incidence age of 65 years.2 Whilst sporadic community3 and familial4,5 clusters have occurred, and indeed, even husband and wife cases,6,7 to date no evidence of genetic predisposition has been discovered.5 Failure to find a definitive environmental cause for the community clusters might suggest that such cases are simply random, given their statistical low incidence relative to Myeloma incidence in general.3,7 Myeloma also affects more men than women, more blacks than whites and at a relatively earlier age than whites, farmers more than the general population.8 A French study noted a 40% excess prevalence, age- and sex-adjusted, amongst farmers, relative to other occupations.9 Other atrisk groups include foresters,8 fishermen.8 veterinarians,10 teachers,11 anaesthesiologists,12 radiologists, and anyone exposed to ionizing radiation. |
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