Trends in Mortality Due to Hematologic Malignancies Among Patients Aged 25 and Older in the United States: Geographic and Metropolitan Area Disparities Insights from CDC Wonder Database

Introduction

Hematologic malignancies represent a significant cause of mortality among adults aged 25 and older in the United States. This study examines geographic and metropolitan area disparities in mortality rates from 1999 to 2020.

Methods

A retrospective analysis of the CDC WONDER database was conducted to calculate age-adjusted mortality rates (AAMRs) per 100,000 persons. Trends were analyzed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC), stratified by geographical regions and metropolitan areas.

Results

From 1999 to 2020, hematologic malignancies caused 1,463,046 deaths among adults aged 25 and older. Geographic analysis revealed that all regions experienced a decrease in AAMR from 1999 to 2018, followed by slight, non-significant increase from 2018 to 2020. The Northeast showed a decrease from 36.72 to 26.38 (APC: -1.7256; 95% CI: -2.7731 to -0.2212; p = 0.0246), with a non-significant rise to 26.96 in 2020. The Midwest had similar trends, with the AAMR decreasing from 39.55 to 28.99 (APC: -1.6203; 95% CI: -1.7705 to -1.5059; p < 0.001) from 1999 to 2018, followed by a non-significant rise to 30.55 in 2020. The South saw a decrease from 35.96 to 26.41 (APC: -1.6129; 95% CI: -2.0725 to -1.4489; p < 0.001) from 1999 to 2018, with a non-significant rise to 27.17 in 2020. The West had a significant decrease from 35.85 to 25.82 (APC: -1.7130; 95% CI: -1.8933 to -1.6040; p < 0.001) from 1999 to 2018, followed by a non-significant rise to 26.45 in 2020. Metropolitan areas consistently had lower AAMRs compared to non-metropolitan areas, with the AAMR in metropolitan areas decreasing from 36.43 in 1999 to 27.19 in 2020, while non-metropolitan areas decreased from 37.77 in 1999 to 30.30 in 2020.

Conclusion

This analysis reveals significant geographic and metropolitan area disparities in mortality rates due to hematologic malignancies among adults aged 25 and older in the U.S. Despite overall declines, there is a persistent higher mortality rate in non-metropolitan areas. Limited healthcare infrastructure, barriers to healthcare accessibility, and social determinants of health are suggested factors contributing to these results. This highlights the need for targeted public health interventions to address these disparities and improve outcomes in rural populations.

No relevant conflicts of interest to declare.