Mortality trends and demographic patterns in malignant neoplasms of independent primary multiple sites in United States, 1999-2023: Analysis of national data from CDC WONDER database.
Year: 2026
Type: conference-abstract
Abstract: 589 Background: Multiple Primary Cancers (MPCs), defined as two or more independent malignant tumors arising in the same or different organs, represent an emerging and increasingly complex challenge in oncology. To date, no national-level analysis has specifically characterized mortality trends for ICD-10 C97 across the United States. This study represents the first comprehensive national investigation of multiple primary neoplasm-related mortality from 1999 to 2023. Methods: Retrospective population-based analysis of CDC WONDER mortality data identified 96,002 deaths attributed to C97. Age-adjusted mortality rates (AAMR) per 100,000 were calculated using the 2000 US standard population. Data were stratified by age group (35-44, 45-54, 55-64, 65-74, 75-84, 85+ years), sex (male/female), race/ethnicity (White, Black or African American, Hispanic or Latino, Asian or Pacific Islander), geographic region (Northeast, Midwest, South, West), and urban-rural classification. Joinpoint regression analyzed temporal trends. Results: National mortality declined from 1999–2015 (APC=-1.78%, p<0.001) but reversed thereafter, increasing +3.09% annually through 2023 (p=0.001). The reversal was universal across all age groups, most pronounced among adults aged 35-44 years (+19.5% per year since 2019, p=0.001). Females experienced a sharp recent increase (+4.17% per year, p<0.001). Black or African Americans showed the only significant net decline over the full period (AAPC=-1.43%, p<0.001), while White populations increased +3.70% annually since 2015. Geographically, the South exhibited the highest age-adjusted mortality rate (3.41 per 100,000), which was 35% higher than the West (2.52 per 100,000). The Northeast was the only region to maintain a significant net decline over 25 years (AAPC = -0.58%, p = 0.013). Urban areas showed net decline (AAPC=-1.20%, p<0.001); rural areas showed no net change (p=0.36). Conclusions: Rising mortality from multiple malignancies, especially among younger adults, women, and rural populations, underscores urgent needs for equitable prevention targeting obesity, viral hepatitis, and HPV, alongside enhanced screening and access to care. Summary of significant key points in our study. Period/Group Trend (APC/AAPC) p-value Key Finding 1999-2015 (Overall) -1.78% (APC) <0.001 Steady decline 2015-2023 (Overall) +3.09% (APC) 0.001 Sharp reversal Age 35-44 (2019-2023) +19.5% (APC) 0.001 Most dramatic rise Black/African American -1.43% (AAPC) <0.001 Only net decline South Region AAMR 3.41 – Highest mortality Rural Areas -0.25% (AAPC) 0.36 No net improvement
Source: JCO Oncology Practice
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7221694537
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