Cancer and intracerebral hemorrhage-related mortality in the United States: A nationwide retrospective study (1999-2023)

Cancer patients with improved survival rates have been paradoxically linked with increased age-associated comorbidities, including Intracerebral Hemorrhage (ICH). Although ICH mortality remains high in cancer patients due to coagulopathy and systemic inflammation, nationwide long-term mortality trends remain understudied. We aim to analyze co-occurring ICH and cancer-associated mortality trends and disparities in the United States.

Death certificate information was analyzed using the CDC WONDER database (1999-2023), considering adults (aged ≥35 years) listing cancer and ICH as underlying or contributing causes of death. Age-Adjusted Mortality Rates (AAMRs) per 1,000,000 were calculated and standardized to the 2000 U S.

Joinpoint regression was utilized to assess temporal trends and calculate Annual Percent Changes (APCs).

Overall, 42,103 deaths occurred, and the AAMR declined significantly from 1999 to 2015 and reversed to a significant increase thereafter (APC 1.86*; 95% CI: 1.19-2.78; p = 0.008798). Males exhibited approximately 1.5 times the average mortality rate of females (12.2 vs. 7.8). Among racial/ethnic groups, Non-Hispanic (NH) African Americans (10.2) bore the highest mortality burden. Geographically, the Midwest region (10.2) and non-metropolitan areas (10.4) reported higher mortality rates compared to their counterparts.

ICH and cancer-related mortality have risen since 2015 following a period of decline, with persistent disparities affecting males, NH African Americans, and non-metropolitan populations. These findings highlight the urgent need for prospective clinical registries to further investigate overlapping cardiovascular and metabolic risk factors within these vulnerable oncology populations.