{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:49:47Z","timestamp":1791413387174,"version":"4.3.3"},"reference-count":19,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"29","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2026,10,10]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Multiple myeloma (MM) and related malignancies develop from an asymptomatic precursor condition, monoclonal gammopathy of undetermined significance (MGUS), detectable via blood testing. The benefits and harms of population-based MGUS screening remain uncertain. We conducted a nationwide screening study for monoclonal gammopathies and a randomized trial of follow-up strategies in Iceland (Iceland Screens, Treats, or Prevents Multiple Myeloma; ClinicalTrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT03327597\">NCT03327597<\/jats:ext-link>\n                      ). In total, 75,422 (53% of those invited) were screened and those with MGUS (n = 3,541) were randomly assigned to no notification (arm 1), guideline-based follow-up (arm 2), or intensified follow-up (arm 3). Progression, symptom burden, and psychological well-being were compared between the control arm (arm 1) and intervention arms (arms 2 and 3). After a median follow-up of 4.5 years, screening led to a 27-fold increase in the detection of smoldering MM (8.6%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.3%; hazard ratio, 27.46 [95% CI, 10.21 to 73.86];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), but active malignancy rates did not differ. Active MM and related malignancy were diagnosed 1 year earlier in the intervention arms with fewer symptomatic presentations and hospitalizations at diagnosis. MGUS notification was not associated with adverse psychological outcomes. These findings demonstrate that population-based screening facilitates earlier detection of MM and expands access to early intervention without detectable psychological harm. Longer follow-up is required to determine the effects on survival and cost-effectiveness.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-02771","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T20:00:22Z","timestamp":1784059222000},"page":"2781-2786","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Psychological Outcomes After Monoclonal Gammopathy Screening: A Population-Based Screening Study and Subsequent Randomized Trial of Follow-Up"],"prefix":"10.1200","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2162-8414","authenticated-orcid":false,"given":"S\u00e6mundur","family":"R\u00f6gnvaldsson","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5017-3530","authenticated-orcid":false,"given":"Sigr\u00fan","family":"Thorsteinsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-7628","authenticated-orcid":false,"given":"Elias","family":"Eythorsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2609-5664","authenticated-orcid":false,"given":"Inga Dr\u00f6fn","family":"Wessman","sequence":"additional","affiliation":[{"name":"Faculty of Psychology, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun Asta","family":"Sigurdardottir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brynjar","family":"Vidarsson","sequence":"additional","affiliation":[{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pall T.","family":"Onundarson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-9965","authenticated-orcid":false,"given":"Bjarni","family":"Agnarsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margret","family":"Sigurdardottir","sequence":"additional","affiliation":[{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isleifur","family":"Olafsson","sequence":"additional","affiliation":[{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingunn","family":"Thorsteinsdottir","sequence":"additional","affiliation":[{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0307-2512","authenticated-orcid":false,"given":"Andri Steinthor","family":"Bjornsson","sequence":"additional","affiliation":[{"name":"Faculty of Psychology, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9201-1166","authenticated-orcid":false,"given":"Jon Thorir","family":"Oskarsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-8431","authenticated-orcid":false,"given":"Andri","family":"Olafsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauti","family":"Gislason","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingigerdur","family":"Sverrisdottir","sequence":"additional","affiliation":[{"name":"Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2377-7886","authenticated-orcid":false,"given":"Thorir E.","family":"Long","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Skane University Hospital, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfa R\u00fan","family":"Gu\u00f0mundsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0430-7302","authenticated-orcid":false,"given":"Asdis Rosa","family":"Thordardottir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2374-9773","authenticated-orcid":false,"given":"Asbjorn","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Akureyri Hospital, Akureyri, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6763-1702","authenticated-orcid":false,"given":"Runolfur","family":"Palsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8509-6598","authenticated-orcid":false,"given":"Olafur S.","family":"Indridason","sequence":"additional","affiliation":[{"name":"Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9045-6495","authenticated-orcid":false,"given":"Malin","family":"Hultcrantz","sequence":"additional","affiliation":[{"name":"Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian G.M.","family":"Durie","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Harding","sequence":"additional","affiliation":[{"name":"Binding Site 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