Myelodysplastic syndrome (MDS), also referred to as preleukemia, is a group of disorders of bone marrow cells that result in abnormal hematopoiesis. This morphologic dysplasia of hematopoietic cells results in peripheral cytopenias [1]. In this study, we aimed to estimate the prevalence of primary MDS by using the Surveillance, Epidemiology, and End Results (SEER) Program database. SEER is a database supported by the Surveillance Research Program under the National Cancer Institute’s (NCI) Division of Cancer Control and Population Sciences (DCCPS) providing cancer statistics for the U.S. population. The goal of quantifying this disease is to understand its prevalence for future research aimed at reducing the cancer burden in U.S. populations.

At the date of data collection, the SEER database had 43,926,825 participants enrolled (Table 1). We estimated an overall count of 5746.7 affected with MDS. The prevalence was estimated to be highest in the 85 plus age group, showing a pattern that increased with age. The prevalence was also estimated to be highest in White individuals at 0.03%. In Black, American Indian/Alaskan Natives, and Asian or Pacific Islander populations, the prevalence was estimated to be 0.02% (Table 1). It is important to note that the SEER database is composed of 71% White, 12% Black, 2% American-Indian, and 15% Asian-Pacific Islanders [2], which differs slightly from the demographic distribution of the United States, which is 76% White, 14% Black, 1% American-Indian, and 7% Asian [3]. Therefore, our calculation of the prevalence of MDS may underestimate the White and Black populations and overestimate the Hispanic and Asian populations. Moreover, there may be a significant number of unaccounted patients due to factors such as their residency status, limited access to healthcare, and census limitations.

A Chi-square test of independence revealed a significant difference in racial distribution between the SEER database and the U.S. Census population (χ² = 3404,209.89; df = 3; N = 304,167,848; p-value <0.001) (Table 2). Given the large sample size, even small proportional differences may reach statistical significance. Although SEER does not perfectly mirror the U.S. population demographically, it remains a widely used, population-based registry for estimating national prevalence. These differences should be considered when interpreting results.

Altogether, our data suggest that MDS is equally prevalent across various ethnic groups. It also suggests that its prevalence increases with age. With its prevalence in all races, we recommend increased awareness and education regarding MDS in minority patients. It would be beneficial to conduct further epidemiological studies that are not limited by billing codes to validate our findings.