Intersectional disparities in mortality of laryngeal cancer: A retrospective analysis.

Abstract

e22538 Background: Laryngeal cancer accounts for around 1% of cancer cases and deaths. Early detection improves prognosis, with a 5-year survival rate of around 80% for localized cases. Key risk factors include smoking, alcohol, age (≥65), males, African Americans, and family history. The annual rate of new cases has been declining by 2-3%, due to improved diagnostic and treatment modalities. Objective: Previous studies relied on outdated data and focused on specific regions, highlighting the need for more research to understand recent trends and disparities in laryngeal cancer mortality across demographic factors which is highlighted in this abstract. Methods: Data on laryngeal cancer-related deaths in the U.S. from 1999 to 2020 were sourced from the CDC WONDER database. Age associated mortality rate (AAMR) per million individuals, along with Annual Percent Change (APC) and 95% confidence intervals were calculated with a p-value set at < 0.05. Trends across demographic groups-were analysed using the Joinpoint Regression Program, adhering to STROBE guidelines. Results: From 1999 to 2020, a total of 108,491 deaths due to laryngeal cancer were recorded in the U.S. The AAMR decreased from 19.245 in 1999 to 12.56 in 2014 (APC: -2.85; p < 0.01), and further declined to 11.77 in 2020 (APC: -1.38; p = 0.002). Overall mortality remained relatively stable, decreasing slightly from 5,275 deaths in 1999 to 5,077 in 2020. Men demonstrated higher AAMRs than women, with significant declines observed in both genders(men: APC -3.34 from 1999-2009, women: APC -2.63 overall). Among men, the AAMR decreased significantly from 1999 to 2009 (APC: -3.34; p < 0.01), but showed a slight increase from 2018 to 2020 (APC: -5.5; p < 0.01). Age-stratified data revealed the highest mortality rates in the 65-74 and 75-84 groups, with significant reductions across all groups, especially in the 55-64 age group (AAMR declined from 47.775 in 1999 to 29.809 in 2020; APC: -2.68; p < 0.01). Racial disparities were evident, with Black or African American individuals having the highest AAMRs (APC: -3.59), followed by Whites (APC: -2.59) and Asian/Pacific Islanders (APC: -3.39). Regionally, California exhibited the highest AAMR, while Alaska had the lowest. The South showed a fluctuating decline (APC: -2.35), while the Northeast, Midwest, and West regions demonstrated more consistent reductions. Metropolitan areas experienced more decrease in AAMR than non-metropolitan areas (APC: -3.36 vs. -1.51; p < 0.01). Conclusions: Although the laryngeal cancer mortality rate has declined over the past years driven by advances in early detection, significant disparities by sex, race, and region persist, highlighting the need for targeted healthcare policies to address access inequities and improve outcomes, especially in California.