Spain's Sarcoidosis Mortality: An Evolving Public Health Challenge

To comprehensively analyze national trends in sarcoidosis mortality in Spain between 1999 and 2023, with a focus on demographic differences and changes over time.

This nationwide ecological study analyzed death registry data for sarcoidosis (ICD-10 code D86) from the Spanish National Institute of Statistics. Age-standardized mortality rates (ASMRs) were calculated by sex and age. Joinpoint regression assessed temporal trends and annual percentage changes (APCs).

Spain recorded 1053 sarcoidosis deaths between 1999 and 2023, with women accounting for 61.8%. Overall deaths rose, peaking at 72 in 2022. Mortality was heavily concentrated among those aged ≥ 65 years (75.8% of deaths). Age-specific mortality rates were negligible under 35, increasing markedly with age. Comparing 1999-2003 and 2019-2023 revealed rising mortality, especially among older adults; for example, men aged 70-74 saw rates increase from 1.22 to 4.06 per million, and women aged 80-84 from 3.24 to 8.40 per million. The male-to-female mortality ratio shifted over time, indicating a growing relative burden among men in several age groups. Joinpoint analysis showed steady ASMR increases: men's overall APC was +4.20%, driven by a 5.81% rise among those ≥65 years, while women's APC was +1.24%, primarily among those ≥65 years.

Sarcoidosis mortality in Spain has risen substantially over 25 years, particularly among older adults and men. These findings underscore the need for targeted management and public health interventions focused on Spain's ageing population.