Analysis of trends and disparities in laryngeal cancer mortality from 1999 to 2020.

Abstract

e18136 Background: Laryngeal cancer (LC) comprises one-third of all head and neck cancers, presenting substantial morbidity and mortality risks. Despite this, its mortality trends remain insufficiently explored. Methods: Data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) for the years 1999 to 2020 to calculate crude and age-adjusted mortality rates (AAMR) per 100,000 population among individuals aged 45 years and older using the International Classification of Diseases (ICD) code C32. Mortality trends were analyzed using annual percent change (APC) and average annual percent change (AAPC), with 95% confidence intervals (CI), through the Joinpoint Regression Program (version 5.3.0). Trends were stratified by age, gender, race/ethnicity, and urbanization status (metropolitan vs. non-metropolitan areas). Statistical significance was set at p < 0.05. Results: Between 1999 and 2020, 107,198 LC-related deaths were reported. The AAMR declined significantly from 1999 to 2017, followed by a slight increase through 2020 (AAPC: -2.27; CI: -2.47 to -2.14). Metropolitan areas experienced a steeper decline (AAPC: -2.66; CI: -2.82 to -2.52) compared to non-metropolitan areas (AAPC: -1.33; CI: -1.72 to -0.92). Non-Hispanics had higher AAMRs (4.20) than Hispanics (2.69). Among non-Hispanics, African Americans had the highest AAMR (6.65) but the steepest decline (AAPC: -3.41; CI: -3.66 to -3.15), while Hispanics showed a slower decline (AAPC: -2.97; CI: -3.34 to -2.55). Mortality increased with age, peaking in those 85 above (CR: 9.40), followed by 75–84 (CR: 9.09). The 45–54 age group showed the sharpest decline (AAPC: -3.04; CI: -3.41 to -2.67), while the 85 above group had the slowest (AAPC: -0.87; CI: -1.55 to -0.49). Men had higher AAMRs (7.39) than women (1.53), with similar declines in men (AAPC: -2.56) and women (AAPC: -2.55). A slight but insignificant rise in both genders occurred from 2018 to 2020. Conclusions: LC mortality declined significantly from 1999 to 2020, conveying advancements in diagnosis and treatment. However, disparities remain, particularly among non-Hispanic African Americans, older adults, and residents of non-metropolitan areas. Addressing these inequities and improving access to care are crucial for sustaining progress and enhancing outcomes.