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Epidemiology and Etiology
Book chapter

Epidemiology and Etiology

Anneclaire J. De Roos
Myelodysplastic Syndromes, pp 9-38
04 May 2013
DOI: https://doi.org/10.1007/978-3-642-36229-3_2

Abstract

Acute Myeloid Leukemia Myeloid Neoplasm Pesticide Exposure Refractory Anemia Unexplained Anemia
Epidemiologic research of MDS has been fairly limited in comparison to other hematopoietic cancers (such as acute myeloid leukemia (AML)), no doubt due to difficulty in case-finding from a historical lack of reporting of MDS in cancer registries. MDS incidence has been recently reported in multiple studies since the International Classification of Diseases for Oncology, 3rd edition listed MDS as malignant, spurring its inclusion in cancer registries worldwide. The largest studies to date report rates (per 100,000 person-years) of 3.3 in the USA, 3.2 in Australia, and 1.8 in Europe. Nevertheless, these are likely underestimates based on evidence of incomplete reporting and underdiagnosis. Accepted causes of MDS are limited at this time to treatment-related chemotherapy and radiation and occupational exposure to benzene. Multiple case–control studies of potential lifestyle and environmental risk factors for MDS have been conducted, usually within the hospital setting. Probable causes, supported by multiple epidemiologic studies as well as similar findings for AML, are smoking, obesity, solvents and pesticides (without knowledge of specific exposures). Future research could contribute importantly with detailed (and preferably quantitative) assessment of specific exposures (e.g., specific types of pesticides), refined definition of homogeneous case groups by patterns of chromosomal abnormalities to identify etiologically relevant subgroups, and expanded investigation to include MDS cases previously missed because of incomplete reporting to registries or “underdiagnosis.”

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