Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.

意义未明的单克隆丙种球蛋白病 (MGUS) 先于多发性骨髓瘤 (MM)。基于人群的 MGUS 筛查可以确定 MM 早期治疗的候选者。在这里，我们描述了冰岛筛查、治疗或预防多发性骨髓瘤研究 (iStopMM)，这是第一个基于人群的 MGUS 筛查研究，包括随访策略的随机试验。1976 年之前出生的冰岛居民可以参与。在冰岛的医疗保健系统中，血液样本与血液样本一起收集。患有 MGUS 的参与者被随机分配到三个研究组。第 1 组未接触，第 2 组遵循当前指南，第 3 组遵循更密集的策略。为取得进展的参与者提供早期治疗。从第 2 和第 3 臂纵向收集样品用于研究生物库。所有参与者都反复回答有关各种暴露和结果的问卷，包括生活质量和精神健康。国家健康登记册与所有参与者交叉链接。在目标人群的 148,704 人中，80,759 (54.3%) 人提供了参与的知情同意书。由于参与率非常高，iStopMM 研究的数据将回答有关 MGUS 的重要问题，包括筛查的潜在危害和益处。该研究可能导致 MM 治疗向筛查和早期治疗的范式转变。由于参与率非常高，iStopMM 研究的数据将回答有关 MGUS 的重要问题，包括筛查的潜在危害和益处。该研究可能导致 MM 治疗向筛查和早期治疗的范式转变。由于参与率非常高，iStopMM 研究的数据将回答有关 MGUS 的重要问题，包括筛查的潜在危害和益处。该研究可能导致 MM 治疗向筛查和早期治疗的范式转变。