Analyzing trends and disparities in polycythemia vera mortality in the U.S. from 1999 to 2020.

Abstract

e18587 Background: Polycythemia Vera (PV) is a rare blood disorder characterized by excessive red blood cell production, leading to an increased risk of thrombosis and mortality, particularly among the elderly. Despite ongoing research, population-based mortality trends remain insufficiently explored. Methods: Data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) from 1999 to 2020 were used to calculate crude and age-adjusted mortality rates (AAMR) per 100,000 population for PV in adults above 65 years of age using ICD Code D45. Mortality trends were analyzed using annual percent change (APC) and average annual percent change (AAPC) via Joinpoint Regression (v5.3.0). Analyses were stratified by age, gender, race/ethnicity, and urbanization (metropolitan vs. non-metropolitan). Statistical significance was set at p < 0.05. Results: Between 1999 and 2020, a total of 18,050 PV-related deaths were recorded in the U.S. The AAMR declined by 35.8%, from 2.87 in 1999 to 1.91 in 2020. A significant decline was observed from 1999 to 2015 (APC: -3.95; 95% CI: -4.46 to -3.52), followed by an increase from 2015 to 2020 (APC: +3.42; 95% CI: 1.10 to 7.17).Among age groups, the 65–74 years age group experienced the most notable decline (AAPC: -2.79; 95% CI: -3.50 to -2.11), whereas the 85 years above age group recorded the slowest reduction (AAPC: -1.37; 95% CI: -2.18 to -0.77). Females showed a greater decline (AAPC: -2.32; 95% CI: -2.88 to -1.94) compared to males (AAPC: -2.05; 95% CI: -3.09 to -1.33).Mortality rates decreased among Whites (AAPC: -1.99; 95% CI: -2.45 to -1.57) and Black populations (AAPC: -1.25; 95% CI: -3.41 to 0.11), whereas an increase was observed among Hispanics (AAPC: +2.54; 95% CI: -3.99 to 10.55). Regionally, the Midwest experienced the steepest reduction in mortality rates (AAPC: -2.35; 95% CI: -3.30 to -1.75), whereas the Northeast experienced the slowest decline (AAPC: -1.39; 95% CI: -2.66 to -0.70). Metropolitan areas exhibited greater declines (AAPC: -2.31; 95% CI: -2.67 to -1.99) compared to non-metropolitan areas (AAPC: -1.20; 95% CI: -2.60 to -0.53). Conclusions: Despite an overall decline in PV mortality from 1999 to 2020, disparities persist in mortality trends and rates of decline across all variables, with recent trends indicating a concerning increase. Public health efforts and targeted strategies are crucial to tackle disparities and rising mortality.