What is known?
Myeloproliferative neoplasms (MPNs) are a group of uncommon blood cancers. They were classified as cancers by the World Health Organisation in 2008, which is relatively recently. Diagnosis of MPNs usually involves clinical evidence (such as blood tests), genetic testing and a bone marrow biopsy. Among cancer types, this requirement of multiple forms of diagnostic evidence is unique to MPNs.
What is new?
We found strong evidence of geographical variation across Australia in diagnosis rates, but no evidence of variation in survival rates.
Areas in Queensland and Victoria generally had very high rates of diagnoses, while most areas in Tasmania and Western Australia had very low rates. Diagnosis rates for MPNs did not vary between city, regional and remote areas, even though some types of MPN are associated with agriculture.
While the percentage of diagnosed cases that had been confirmed by bone marrow biopsy and rates of genetic testing varied for each state or territory, this variation was not consistent with the diagnostic patterns.
What does this mean?
Reasons for the geographical patterns for diagnoses are unclear, but may include real differences by geographical area, differences in the way cases are reported to the population-based cancer registries, or differences in diagnostic or management practices by clinicians.
Understanding the reasons for these geographical patterns will require details on the clinical characteristics of the diagnosed cases, as well as detailed descriptions of the diagnostic processes, including genetic testing, in each state and territory. Much of this information is currently not being collected on a population basis.
The results of this study should stimulate efforts to collect and report these data using consistent methods.
Until this is done, efforts to reduce disparities in diagnosis and management practices for MPNs will not be evidence-based, reducing the potential for these activities to reach best practice throughout the country.
Contact: Jess Cameron
Reference: Cameron J, Fritschi L, Ross D, Anderson L, Baade P. Spatial disparities in the reported incidence and survival of myeloproliferative neoplasms in Australia. Pathology. 2021. doi: 10.1016/j.pathol.2021.06.122.