Stratified analysis of mesothelioma mortality: A 21-year atlas of trends and demographic shifts in the United States.

Abstract

e20094 Background: Mesothelioma is a malignant neoplasm that mostly affects the pleura (85%). With a median survival duration of 12 months, it is classified as one of the atypical but aggressive tumors, with a dismal prognosis. This study aims to analyze mesothelioma mortality trends in the U.S. over 21 years, focusing on age-adjusted mortality rates (AAMR), demographic disparities, and geographic variations. Methods: Utilizing the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, participants were identified using specific ICD-10 codes for various types of mesothelioma, targeting individuals aged 25 and older due to the disease's association with occupational exposure and long latency period. Data extraction involved retrieving age-adjusted mortality rates (AAMR) per million individuals with 95% confidence intervals across all states and including demographic information such as gender, race/ethnicity, and geographic location. Statistical analyses were performed to assess mortality trends and the Joinpoint Regression Program to evaluate average annual percent changes (AAPC) in AAMR. Results: Between 1999 and 2020, mesothelioma caused approximately 58,670 deaths in the United States, with an average of about 2,800 deaths annually (AAPC: -1.72; CI, -1.99 to -1.44). Males had much higher AAMR (23.2) as compared to females (4.6) with an AAPC of -2.23 (CI; -2.51 to -1.96). AAMR was highest in the age group 65+ (52.6) (AAPC: -1.22; CI, -1.44 to -0.97), followed by the 45-65 age group (5.4), and lastly the 25-44 age group (0.5). The White population had a higher AAMR (14) (AAPC: -1.55; CI, -1.75 to -1.34) than Hispanics (7.0) and Black or African American (5.7). The Northeast Census Region had the highest AAMR (14.0), followed by Midwest (13.6), West (12.4), and lastly South (10.7). The state of Alaska had the highest AAMR (18.8). Lastly, the metropolitan areas (12.4) had higher AAMR than non-metropolitan areas (12.0). Conclusions: Despite a decrease in mesothelioma mortality, notable disparities persist, including racial and regional differences, as well as a higher mortality rate in males and metropolitan areas and the state of Alaska. These disparities underscore the need for ongoing research to understand better the factors driving differences in mesothelioma incidence and outcomes. Demographic characteristics of deaths due to mesothelioma in the United States from 1999-2020. Variable Subgroup Deaths AAMR (95% CI) per 1000,000 Overall Overall 58,670 (100%) 12.4 (12.3-12.5) Gender a Male 46,443 (79.20%) 2.78 (2.76-2.8) Female 12,227 (20.80%) 4.6 (4.5-4.7) Race a Hispanic or Latino 2,589 7 (6.7-7.3) Black or African American 2,456 5.7 (5.4-5.9) White 52,712 14 (13.9-14.1) Age (years) 25-44 824 0.5 (0.4-0.5) 45-64 9,977 5.4 (5.3-5.6) 65+ 48,769 52.6 (52.1-53.1) a Age-Adjusted Mortality Rate (AAMR) is utilized.