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Disparities in Chronic Myeloid Leukemia Mortality Trends in the United States: A Population Based Analysis
Michael Roberts1, Dawood Shehzad2, Tate Blankespoor1
1University of South Dakota Sanford School of Medicine.
Insights
Chronic myelogenous leukemia (CML) mortality declined overall in the U.S. from 1999-2020, but disparities by sex, race, and region persist, with a recent uptick observed.
Area of Science:
- Hematology
- Oncology
- Public Health
Background:
- Chronic myelogenous leukemia (CML) is a significant myeloproliferative neoplasm.
- Therapeutic advancements have improved outcomes, but mortality trends require ongoing surveillance.
Purpose of the Study:
- To analyze trends in CML-related mortality in the U.S. from 1999 to 2020.
- To investigate disparities in CML mortality based on sex, race, and geographic region.
Main Methods:
- Utilized CDC Wonder database for retrospective analysis of CML deaths in individuals aged 45 and older.
- Calculated age-adjusted mortality rates (AAMR), annual percentage change (APC), and average annual percentage change (AAPC) using joinpoint regression.
Main Results:
- Total U.S. CML deaths: 32,484 (1999-2020).
- Age-adjusted mortality rate (AAMR) declined significantly, particularly from 1999-2006, then plateaued.
- Males and White individuals showed higher AAMRs; Asian individuals had the lowest rates. The Midwest region had the highest AAMR.
- A slight increase in AAMR was noted across all demographic groups from 2018-2020.
Conclusions:
- Significant disparities in CML-related mortality exist across sex, race, and census regions.
- The observed recent increase in mortality warrants further investigation and targeted interventions.
Introduction:
Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm with an annual diagnosis rate of 93,000 individuals in the U.S. per year. Advances in therapy have reduced mortality. In this study, we aim to explore trends of CML-related mortality in the U.S. from the years 1999 to 2020 as they pertain to sex, race, year, state and census region.
Methods:
CDC Wonder retrospectively identified patients with an age ≥ 45 with CML-related deaths. Data points analyzed included mortality related to sex, race, year, and census region. Statistical analysis for age adjusted mortality rate (AAMR) per 100,000 persons, annual percentage change (APC), and average annual percentage change (AAPC) were calculated via joinpoint regression.
Results:
Between 1999 and 2020, there were 32,484 CML-related deaths in the U.S. The AAMR declined across the entire study period. There was a pronounced decrease from 1999 to early 2006 (APC -8.50% for males and -8.30% for females, with the decline plateauing in the following years). Males exhibited higher AAMRs than females throughout the study period. White individuals appeared to have a higher AAMR than black and Hispanic individuals, while Asian individuals (as reported in national datasets) had the lowest rates. The Midwest has a higher AAMR followed by the West, the South, and the Northeast. Notably, from 2018 to 2020, a slight increase in AAMR was observed across all groups.
Conclusion:
Disparities of CML related mortality were observed as they relate to sex, race, year, state and census region.
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