Analyzing trends in vulvovaginal cancer mortality in the United States from 1999 to 2020.

Abstract

e17654 Background: Vulvovaginal cancer’s (VC) representing distinct malignancies of the vulva and vagina are rare malignancies with significant mortality disparities across demographic and geographic groups. This study aimed to assess trends and disparities in VC mortality in adults aged 55 years and older in the United States from 1999 to 2020. Methods: Data was extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC-WONDER) from 1999–2020 to calculate crude and age-adjusted mortality rates (AAMR) per 100,000 population for VC using ICD Codes C51 and C52. Mortality trends were analyzed using annual percent change (APC) and average annual percent change (AAPC) through the Joinpoint Regression Program (v5.3.0). Analyses were stratified by age, gender, race/ethnicity and urbanization status (metropolitan vs. non-metropolitan areas). Statistical significance was defined at p < 0.05. Results: A total of 33,213 VC-related deaths were reported from 1999 to 2020. Overall, the AAMR increased from 3.594 in 1999 to 3.964 in 2020, with an average annual percent change (AAPC) of 0.49 (95% CI: 0.20 to 0.73). The highest crude mortality rate was observed in individuals aged 85+ years (13.531), although this age group experienced a decreasing mortality trend (AAPC: -0.59, 95% CI: -0.92 to -0.14). Regional disparities were noted, with the Midwest exhibiting the highest AAMR (4.015), followed by the Northeast (3.874), South (3.329), and West (3.117). The Northeast showed the largest increase in mortality (AAPC: 0.82, 95% CI: 0.14 to 1.32). AAMR was higher in non-metropolitan areas (3.999) compared to metropolitan areas (3.419), with a significant mortality increase in metropolitan areas from 2014 to 2020 (APC: 1.95, 95% CI: 0.72 to 5.69). Non-Hispanic populations exhibited higher AAMRs (3.613) than Hispanic populations (2.633). Among non-Hispanic groups, White individuals had the highest AAMR (3.806), while mortality rates decreased in Hispanic (AAPC: -0.81, 95% CI: -1.71 to 0.38) and Black or African American populations (AAPC: -1.21, 95% CI: -2.03 to -0.31) but increased in White populations (AAPC: 0.99, 95% CI: 0.76 to 1.24). Conclusions: VC mortality in the United States has slightly increased, with specific populations, including non-metropolitan residents and White individuals, experiencing a disproportionate burden. Targeted interventions are needed to address these disparities and improve outcomes.