Temporal trends of mortality due to mesothelioma among older adults in the United States: A CDC WONDER analysis on gender and race disparities.

Abstract

e20097 Background: Malignant mesothelioma (MM) is a deadly cancer of the serous membranes with a dismal prognosis. Between 1990 and 2017, it killed between 18200 and 32400 people worldwide, potentially depleting healthcare resources in wealthy nations. This study determines the mortality trends among various demographic variables in the United States between 1999 and 2020. Methods: Mortality trends for mesothelioma were extracted from the CDC WONDER database for patients above 55 in the United States between 1999-2020 using ICD-10: C45. Age-adjusted mortality rates (AAMR) per 1,000,000 at a significant threshold of p<0.05 were calculated by gender, race, place of death, urbanization, and geographic location per state. Joinpoint Regression Program 5.3.0.0 was used to compute annual percentage change (APC) and average annual percentage change (AAPC). Results: An overall of 55523 deaths occurred due to mesothelioma between 1999 to 2020, with an average AAMR of 35.2 showing a steady decline from an AAMR of 39.3 in 1999 to 37.4 in 2011 (APC: -0.53) subsequently followed by an abrupt fall to AAMR of 27.8 in 2020 (APC: -3.09). Higher mortality trends were observed in males (67.4) compared to females (12.2) during the study. Meanwhile, non-Hispanic whites (39.9) had shown higher AAMRs than Hispanics (19.4) and non-Hispanic African Americans (15.6). Of all fatalities, 53.23% occurred in the decedent's home, followed by medical facilities (28.79%), nursing homes (10.19%), and hospice facilities (7.79%), which had the fewest deaths. According to the 2013 Urbanization classification, medium/small metropolitan areas (36.4) had the highest AAMR, followed by large metropolitans (35.1), with non-metropolitans (33.6) having the lowest. Among states, the highest AAMR was observed in Maine (60.5), with the least in Hawaii (19.6). Conclusions: Males in non-Hispanic white populations living in medium/small metropolitan areas had the highest mortality. This demands timely and strategic healthcare interventions to prevent the loss of healthcare resources.