Demographic and regional trends in female genital neoplasm mortality in the United States from 1999 to 2020.

Abstract

e13807 Background: Female malignant genital neoplasms (FMGNs), including cervical, ovarian, uterine, and vulvar cancers, collectively contribute significantly to cancer-related morbidity and mortality. Despite advancements in screening and early detection, mortality rates remain concerning with limited data on trends for this group. This study examines demographic and regional trends in FMGN mortality from 1999 to 2020, with a focus on disparities present across different age groups, races, census regions/divisions, in the United States. Methods: We analyzed mortality data for FMGNs (ICD-10 codes C51-C58) from the CDC Wonder Database (1999-2020). Age-adjusted mortality rates (AAMR) per 100,000 deaths were calculated and stratified by age groups (35-44, 45-54, 55-64, 65-74, 75-84, 85+), race, year, and census regions/divisions. Temporal trends were assessed using Joinpoint regression software to determine the annual percent change (APC) and average annual percent change (AAPC), with statistical significance set at p < 0.05. Results: From 1999 to 2020, FMGNs accounted for 628,112 deaths in the United States, with the overall AAMR decreasing from 18.2 in 1999 to 15.3 in 2020. However, significant disparities in mortality persist. Racial comparisons show African Americans exhibit a higher AAMR (25.2 in 1999 and 20.5 in 2020) compared to other racial groups (APC -2.4% from 2001 to 2020 (p < 0.05). Older adults, particularly those aged 85+, experienced the highest crude death rates, with AAMR decreasing from 82.0 in 1999 to 60.0 in 2020 (APC of -1.95%, p < 0.05).The Northeast had the highest AAMR, decreasing from 19.75 in 1999 to 15.8 in 2020 (APC -1.04%, p < 0.05). The Middle Atlantic region exhibited the highest mortality, with AAMR declining from 20.25 to 16.3 from 1999 to 2020 (APC -1.04%, p < 0.05). Conclusions: While FMGN mortality has declined overall, significant disparities persist, particularly among African Americans, older adults, and individuals in the Northeast United States. Addressing these disparities is essential for further reducing FMGN-related mortality. Trends in FMGN-related mortality. Demographic FMGN deaths, n (%) AAPC (Statistical Significance) Overall Population 628,112 (100%) Census Region  Northeast 129,595 (20.6%) -1.04% (p < 0.01)  Midwest 144,326 (23.0%) -0.94% (p < 0.01)  South 225,026 (35.8%) -0.92% (p < 0.01)  West 129,165 (20.6%) -0.85% (p < 0.01) Race/Ethnicity  African American 82,127 (13.1%) -0.70% (p <0.01)  White 525,595 (83.7%) -0.99% (p <0.01)  Asian/Pacific Islander 17,348 (2.8%) -0.18% (p = 0.31)  American Indian 3,042 (0.5%) -0.02% (p = 0.76) Age  35-44 years 25,927 (4.1%) -0.77% (p < 0.01)  45–54 years 69,638 (11.1%) -0.90% (p < 0.01)  55–64 years 130,727 (20.8%) -0.71% (p < 0.01)  65–74 years 163,871 (26.1%) -0.71% (p < 0.01)  75–84 years 152,828 (24.3%) -1.12% (p < 0.01)  85+ years 85,121 (13.6%) -1.46% (p < 0.01)