Trends in mortality from endocrine neoplasms in the United States: A CDC WONDER analysis (1999–2020).

Abstract

e23218 Background: Endocrine neoplasms (EN) are invasive tumors of ductless glands with significant mortality risks. Over the past two decades, mortality rates have risen, warranting further attention. This study examines mortality trends across demographic groups in the United States from 1999 to 2020. Methods: Data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC-WONDER) from 1999–2020 to estimate crude and age-adjusted mortality rates (AAMR) for EN patients over 45 years of age using ICD Codes C73, C74, and C75. 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: From 1999 to 2020, 57,927 EN deaths were recorded in the U.S. AAMR increased from 2.124 in 1999 to 2.398 in 2020 (AAPC: 0.55; 95% CI: 0.32–0.78). Non-metropolitan areas experienced higher AAMR increases (AAPC: 1.03, 95% CI: 0.64–1.44) compared to metropolitan areas (AAPC: 0.14, 95% CI: -0.09–0.33). AAMR in non-metropolitan areas increased from 2.01 to 2.67, while in metropolitan areas, it increased from 2.18 to 2.34. Hispanic populations had higher AAMR (2.33) than non-Hispanics (2.22). Asian or Pacific Islanders showed the highest AAMR (2.36), with a sharp rise from 1999 to 2008 (APC: 1.93, 95% CI: 0.20–12.65) and decline from 2008 to 2020 (APC: -1.27, 95% CI: -9.31 to -0.12). Mortality rates increased with age, peaking in individuals aged 85+ (CR = 8.68). The 55–64 age group saw a slight mortality decline (AAPC: -0.08, 95% CI: -0.59 to 0.44). Males and females had nearly equal AAMR (2.26 and 2.2, respectively). Male mortality declined from 1999 to 2003 (APC: -2.26, 95% CI: -5.87 to 0.32) but rose from 2003 to 2020 (APC: 1.02, 95% CI: 0.78–1.40). Female mortality consistently increased (APC: 0.34, 95% CI: 0.18–0.63). Conclusions: Mortality from endocrine neoplasms has risen, with disparities across age, race/ethnicity, and geography. Targeted interventions are crucial to address these disparities and mitigate rising mortality.