Trends in mortality due to CNS neoplasms in the US from 1999 to 2020.

Abstract

e14019 Background: CNS neoplasms are a major public health concern in the U.S., leading to substantial mortality. Despite advancements in diagnosis and treatment, disparities persist across demographic and geographic factors, as evidenced by our study findings. Methods: Data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC-WONDER) for the years 1999 to 2020 to calculate crude and age-adjusted mortality rates (AAMR) per 100,000 population for CNS neoplasms using ICD codes C70.0–C72.9, D32.0–D33.9, and D42.0–D43.9. Mortality trends were analyzed using annual percent change (APC) and average annual percent change (AAPC) through the Joinpoint Regression Program (v5.3.0). Analyses were stratified by age, gender, race/ethnicity, and urbanization status (metropolitan vs. non-metropolitan areas). Statistical significance was defined at p < 0.05. Results: Between 1999 and 2020, a total of 384,041 deaths related to CNS neoplasms were recorded in the U.S. The AAMR declined from 16.60 to 14.23 per 100,000 population, with an AAPC of -0.85 (95% CI: -0.95 to -0.74; p < 0.0001). The most pronounced decline occurred from 1999 to 2008 (APC: -1.56; 95% CI: -2.04 to -1.25), followed by a slower decline from 2008 to 2020 (APC: -0.31; 95% CI: -0.50 to -0.04). Females had more reduction than males, with an AAPC of -0.97 (95% CI: -1.09 to -0.82) versus -0.76 (95% CI: -0.87 to -0.66), respectively. Mortality rates decreased across all age groups, with the most significant decline observed in the 45–54 age group (AAPC: -1.12; 95% CI: -1.40 to -0.78). Metropolitan areas exhibited greater decline compared to non-metropolitan areas, with an AAPC of -0.85 (95% CI: -0.95 to -0.74) versus -0.64 (95% CI: -0.89 to -0.34), respectively. Regionally, the South saw the largest decline (AAPC: -0.94; 95% CI: -1.10 to -0.75), while the West had the smallest (AAPC: -0.72; 95% CI: -0.90 to -0.54). Among racial groups, African Americans faced the largest decline (AAPC: -0.80; 95% CI: -1.28 to -0.35), while Pacific Islanders experienced a slight, non-significant increase (AAPC: 0.12; 95% CI: -0.36 to 0.77). Conclusions: CNS neoplasm mortality declined in the U.S. from 1999 to 2020, with notable variations across demographic groups. Advancements in screening and increased medical awareness likely contributed to this trend. Nonetheless, persistent racial disparities emphasize the need for targeted interventions to address inequities and improve health outcomes.