Myeloma risk modestly increased in adults with an incidentally detected vertebral fracture

A study published in the journal Leukemia reveals a modestly increased risk of myeloma among adults who have an incidentally detected vertebral fracture. Conducted by Rasmus Rønnemoes and colleagues from Copenhagen University Hospital, the research examined 9,059 participants aged 40 to 94 from the Copenhagen General Population Study who underwent CT scans. Vertebrae compression fractures were identified in 17.3% of the participants, with 9.6% experiencing grade 1 fractures and 7.7% experiencing grades 2 or 3 fractures.

The researchers discovered that individuals with any vertebral fracture had a higher relative risk of developing myeloma compared to those without such fractures (multivariable-adjusted hazard ratio of 3.73). This risk was even more pronounced in those with grade 2 to 3 vertebral fractures (hazard ratio of 4.99). When considering absolute five-year risks of myeloma, the findings indicated that women with no vertebral fractures had a 0.07% risk, those with grade 1 fractures had a 0.17% risk, and those with grades 2 to 3 fractures had a 0.43% risk.

In men, the respective risks were 0.10%, 0.24%, and 0.63% for no fractures, grade 1 fractures, and grades 2 to 3 fractures.

Although the absolute five-year risk of myeloma remains modest, even among the oldest participants with grade 2 to 3 vertebral fractures, the absolute risks were still low. At 80 years of age, women with grades 2 to 3 fractures had a 1.11% risk, while men had a 1.56% risk. The study authors concluded that routinely evaluating individuals with incidentally detected vertebral fractures for underlying myeloma or other nonhematologic cancers may offer little benefit without the presence of other suspicious clinical findings, such as symptoms.