Malignant neoplasms of central nervous system: Demographic and geographical disparities in the United States from 1999-2022.

Abstract

e14024 Background: With an average 5-year survival rate of 35.6%, malignant neoplasms of the Central Nervous System (CNS) are considered aggressive tumors with a dismal prognosis. We identified disparities and trends of mortality owing to malignant neoplasm of CNS in the United States (US) to form targeted interventions for the vulnerable demographics. Methods: We examined the mortality trends stratified by sex, census region, race/ethnicity, and urbanization in CNS malignant neoplasms (ICD-10 codes: C 70-72) among adults aged 25+ using mortality data from the CDC WONDER database. Age-adjusted mortality rates (AAMRs), Annual Percent Change (APC) and the average APC (AAPC) along with a 95% confidence interval (CI) were analyzed and p<0.05 was deemed statistically significant. Results: There were a total of 357,752 fatalities due to CNS cancers. AAMR decreased significantly from 71.73 (95%CI: 70.48 to 72.97) in 1999 to 63.73 (95%CI: 62.62 to 64.84) in 2006 with an APC of -1.33% (95%CI: -2.84 to -0.70). Afterwards, the AAMR increased to 67.86 (95%CI: 66.86 to 68.87) in 2022 with the APC of 0.40% (95%CI: 0.23 to 0.65). Several disparities were observed across demographic and geographical groups. Males exhibited a much higher mortality rate than females (AAMR 82.66 vs 54.42 respectively). A test for parallelism revealed a significant difference in AAPC values between males and females (-0.159, 95% CI: -0.304 to -0.0143, p=0.031), highlighting a more pronounced increasing mortality trend among males. Non-Hispanic (NH) Whites had the highest AAMR (76.59; 95%CI: 75.23 to 77.96), followed by Hispanics (44.06), non-Hispanic Blacks (40.16), American Indians (36.32), and Asians (31.08). Asians had a significant increase in AAMR from 1999 to 2022 with an AAPC of 1.17% (95%CI: 0.62 to 1.87). Regionally, The Midwest region had the highest average AAMR (70.83; 95%CI: 68.42 to 73.23). The AAMR in this region stayed relatively unchanged from 1999-2022 (AAPC: -0.13, 95%CI; -0.28 to 0.02). Geographically, rural areas had higher AAMR (66.09) than urban areas (60.79). States in the 90 th percentile for AAMR were South Dakota (84.74), Vermont (80.06), Washington (79.75), Idaho (79.74), and Mississippi (78.99). Conclusions: CNS cancer mortality has been increasing since 2006. Concerning disparities exist in certain groups. Males, NH Whites, Midwest census region, rural areas, and South Dakota showed disproportionately higher mortality rates, underscoring the need for demographically tailored interventions directed at these groups to reduce AAMR. CNS malignant neoplasms deaths in U.S. Variable Subgroup Deaths AAMR (95% CI) per 1000,000 Overall Overall 357,752 67.32 (66.22-68.42) Sex Male 200,340 82.66 (80.84-84.47) Female 157,412 54.42 (53.08-55.77) Race Hispanic 21,824 44.06 (40.91-47.22) Asian 7,467 31.08 (27.35-34.8) Black 21,601 40.16 (37.44-42.89) White 304,912 76.59 (75.23-77.96)