多发性骨髓瘤筛查教育

Background: The lack of federal screening guidelines and limited knowledge of multiple myeloma (MM) among the public and primary care providers contributes to late-stage detection of MM when the disease is harder to treat. Black Americans over 50 are at higher risk for MM but are often diagnosed later than other groups. Given similar or improved outcomes with early detection, this study aims to implement a multi-level community-based intervention. Improved health literacy about cancer risk can lead to better decision making in MM care. Methods: To encourage MM screening in Black Americans, our study engaged providers in continuing medical education seminars (CME), provided brochures with basic MM education at health fairs, and engaged high-risk individuals in on-site MM screening and a knowledge retention pre-test and post-test. A multidisciplinary team created the CME, which included information about the MM disease process, the benefits and methods of early detection and how to address abnormal results. Community events were designed for screening and included participation from outreach staff, navigators, clinicians, and phlebotomists. Participant education relied on an original community brochure that included information such as defining MM, its symptoms and its prominence among Black Americans. Knowledge retention questions were designed by the clinical team to highlight information covered in the brochure. Results: Participants were recruited via convenience sampling from June 2023 through December 2024. The robust educational program included training 46 health care providers in three CME seminars, conducting 22 screening events, and providing education and monoclonal protein screening to identify MM and its precursors for 199 Black individuals over age 50. Overall scores on MM knowledge measures were consistent with a mean score of 2.8 on a five-point scale immediately after exposure to educational materials to 2.9 after at least one week had passed and screening results had been provided. The lack of decline in the score suggests that participants retained the knowledge about MM that they gained during their participation in screening. Screening results identified 21 participants (11%) with Monoclonal Gammopathy of Undetermined Significance (MGUS), a precursor condition to MM, all of whom received follow-up care. Conclusions: Our community-based screening program combined educational opportunities for providers and patients alongside on-site screening to identify individuals with MM precursor conditions in high-risk populations. Further research should aim to expand the reach of interventions and to recruit randomized samples to allow for measurement of baseline knowledge and to generalize findings. Screening programs that meet high-risk populations in their community, intervene at multiple levels, and educate people about their risk can be effective ways to identify the individuals most likely to benefit from MM screening.