The causes of MDS are not fully understood, and there is currently no clear prevention strategy.

The risk factors for developing MDS include the following:

• Age – MDS affects older people, and 93 per cent of all those diagnosed are over the age of 60.
• Gender – MDS is more common in males than females.
• Exposure to environmental/occupational hazards – long-term exposure to benzene, tobacco smoke, insecticides, radiation and other toxins may increase the risk of developing MDS.
• Previous chemotherapy or radiation treatment – treatment using alkylating agents and purine analogues, radiotherapy or ionising radiation may increase the risk of developing secondary MDS.
• An inherited predisposition to MDS is seen in one-third of paediatric MDS patients, including Down syndrome, Fanconi’s anaemia and neurofibromatosis. Work-up for such inherited syndromes may be considered when reviewing a young patient with MDS.

While there is no evidence linking lifestyle changes to reduced risk of MDS, it remains important to encourage people to reduce modifiable risk factors for other types of cancer and health conditions. This includes preventing or reducing obesity, and support to quit smoking.

Patients with mild cytopenia can be identified early on by full blood examination. Others may present with symptoms such as fatigue, bruising or recurrent infections (see section 2.1 Signs and symptoms).

Some patients with cytopenia may not meet the criteria for MDS and may be categorised as clonal cytopenia of uncertain significance. The clinical significance of such a diagnosis is uncertain, and follow-up with general practitioner (until more severe cytopenia(s) occur) may be appropriate for such patients.

Routine screening for MDS is not currently recommended in either the general population or in relatives of people with MDS.