Israeli-born offspring of Jewish immigrants of Middle Eastern origin have a lower incidence of multiple myeloma than those of European origin: a cohort study of 746 200 Israeli men followed from late adolescence.

Differences in the prevalence of multiple myeloma across races have been observed, with a two- to three-fold greater prevalence in African Americans compared with Caucasians. Little is known about the incidence or prevalence of multiple myeloma in other populations. The association between father's country of origin and the incidence of multiple myeloma was examined in a nationwide population-based cohort. Health-related data on 746 200 16-19-year-old Jewish males examined between 1967 and 1998 were linked to the Israel National Cancer Registry to derive multiple myeloma incidence up to 2006. During 17 352 349 person-years of follow-up, 109 examinees developed plasma cell dyscrasias. Middle Eastern origin was protective compared to European origin (hazard ratio [HR] 0.39; 95% confidence interval [CI] 0.22-0.68; p = 0.001, adjusted for year of birth), and also when restricted to Israeli-born males (HR 0.44; 95% CI 0.24-0.82; p = 0.01). In conclusion, second-generation adolescents of Middle Eastern origin are at persistently lower risk of developing multiple myeloma compared to those of European origin, supporting a genetic component in the pathogenesis of multiple myeloma.