Trends in Mortality Due to Hematologic Malignancies Among Patients Aged 25 and Older in the United States: Racial and Ethnic Disparities, Insights from the CDC Wonder Database

Introduction

Hematologic malignancies significantly impact mortality among adults aged 25 and older in the United States. This study investigates racial and ethnic disparities in mortality rates from 1999 to 2020.

Methods

Data from the CDC WONDER database (1999-2020) were retrospectively analyzed to calculate age-adjusted mortality rates (AAMRs) per 100,000 persons. Trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC), stratified by race/ethnicity.

Results

Between 1999 and 2020, hematologic malignancies caused 1,463,046 deaths among adults aged 25 and older. White and Black populations had the highest AAMRs, followed by Hispanics, American Indians and Alaska Natives, as well as Asian, Asian American and Pacific Islanders. White populations saw a significant decrease in AAMR from 1999 to 2018 (APC: -1.5114; 95% CI: -1.6751 to -1.3964; p < 0.001), followed by a slight non-significant increase from 2018 to 2020 (APC: 1.3750; 95% CI: -0.9371 to 2.3460; p = 0.1382). Similarly, Black populations experienced a significant decline in AAMR from 1999 to 2018 (APC: -1.5083; 95% CI: -1.7281 to -1.3535; p < 0.001), with a non-significant increase from 2018 to 2020 (APC: 2.5566; 95% CI: -0.3603 to 4.1183; p = 0.0853). Hispanics saw a significant decrease in AAMR from 1999 to 2018 (APC -1.33; 95% CI: -3.46 to 2.68; P= 0.080), followed by slight non-significant increase in AAMR from 2018-2020 (APC 2.18; 95% CI: -1.38 TO 4.50; P=0.560). American Indian or Alaska Native saw decline in AAMR from 1999 - 2020 (APC -1.17; 95% CI -1.91 to -0.29; P=0.0099) while Asian or Pacific Islanders saw significant decline in AAMR from 1999-2020 (AAPC -1.52; 95% CI -1.69 to -1.24); P<0.001.

Conclusion

This study highlights significant racial and ethnic disparities in mortality rates due to hematologic malignancies among adults aged 25 and older in the U.S. Despite overall declines, there remains a persistently higher mortality rate among White and Black populations compared to Hispanic, American Indian and Alaska Native, as well as Asian, Asian American, and Pacific Islander populations. These findings indicate that race and ethnicity impact survival across multiple hematologic malignancies, necessitating further investigation into the factors driving these differences. The relationship between environmental exposures and disparities in incidence and clinical presentation should be explored in future studies to develop multilevel explanatory models, investigate interventional trials, and create preventive strategies.

No relevant conflicts of interest to declare.