Mortality From Amyotrophic Lateral Sclerosis in Finland 1987–2022

Gender Disparities In Heart Failure Related Mortality Rates Among Older Adults; Data From CDC Wonder 1999-2019

Ethnic And Racial Disparities In Heart Failure Related Mortality Rates Among Older Adults; Data From CDC Wonder 1999-2019

Temporal Trends in Rural vs Urban Sepsis-Related Mortality in the United States, 2010-2019

Chronic lymphocytic leukemia mortality among u.S adults aged ≥65: A 56-year trend analysis and demographic disparities

Background Meningiomas are the most common primary neoplasm of the central nervous system. Previous research on the incidence of meningioma in Finland showed an increase in the age-standardized incidence rate over three decades (1968–1997). In this study, we analysed meningioma incidence in Finland during 1990–2017. Materials and methods Data on 9842 meningioma patients were obtained from the Finnish Cancer Registry, and population size by calendar year, sex, and age group from Statistics Finland. The European Standard Population was used to calculate age-standardized incidence rates. Poisson regression was used to evaluate differences by sex and age, and joinpoint regression to examine changes in trend. Results At the beginning of the study period, the age-standardized incidence of meningioma for men was 2.35/100,000 and for women 6.96/100,000. In the end, it was 4.09/100,000 and 10.19/100,000, respectively. The annual percent change (APC) for women was +4.6 (95% confidence interval, CI 3.10 to 6.20) from 1990 to 2001 and −1.0 (95% CI −1.70 to −0.30) from 2001 to 2017. For men, the APC was +3.1 (95% CI 0.80–5.40) during 1990–2002 and −0.9 (95% CI −2.10 to 0.30) in 2002–2017. The incidence of meningioma in women was 2.8 times higher than in men (rate ratio 2.81; 95% CI 2.68–2.94). Conclusions Meningioma incidence increased in both sexes from 1990, but the trend reversed in 2001–2002. Medical imaging or risk factors do not appear to explain the changes.

Trends in sepsis-related mortality among patients with Acute Myeloid Leukemia: A 24-year nationwide analysis

Background: Pericardial Diseases (PD) have become a significant cause of morbidity and mortality over the last two decades. They contribute secondarily to deaths associated with other primary illnesses and can present clinically as pericarditis, pericardial effusion, and hemopericardium. Despite treatment advances, U.S. mortality trends for PD are unexplored. Aim: This study aims to assess the trends in PD-related deaths in the United States from 1999 to 2022. Methods: PD-related deaths in adults aged 25 years and above were identified through CDC WONDER database from 1999 to 2022 from multiple causes of death. Crude mortality rates and age-adjusted mortality rates (AAMR) per 100,000 population were determined. Joinpoint regression was used to examine changes in trends and annual percentage change (APC) overall, and then stratified by sex, ethnicity, and age groups. Results: A total of 105,536 deaths occurred from PD between 1999 to 2022. Overall, AAMR related to PD decreased from 1999 (2.4) to 2012 (1.7) (APC -2.73 [95% CI, -3.09 to -2.36]), then gradually increased until 2019 (2.0) (APC 2.92 [95% CI, 1.57 to 4.29]), followed by a sharp increase until 2022 (APC 7.65 [95% CI, 4.42 to 10.99]). After an initial decline, APC in AAMR increased in women (4.36) starting in 2012, while in men, it decreased significantly until 2011 (-2.26), followed by a slight increase until 2016 (1.05), and then a marked increase from 2016 to 2022 (4.19). After an initial decline, AAMR increased among non-Hispanic (NH) Blacks (APC 5.42) and NH Whites (APC 4.95) starting in 2014, among Hispanics (APC 4.10) from 2012 to 2022, and among NH Asian or Pacific Islanders (APC 2.4) from 2007 to 2022. Mortality rates have been steadily increasing across all age groups over the last decade, with the highest increase seen recently in the 85+ age group (2017-2022 APC 9.09 [95% CI, 6.50 to 11.76]). Conclusion: PD-related mortality has increased over the last decade. Mortality among males, NH Blacks, and the 85+ age group has been growing at a faster rate than any of the other groups. These results highlight the need for further investigation into the factors contributing to the observed disparities and trends in PD mortality rates.

Introduction: Supraventricular tachycardia (SVT) is known to affect children and teenagers predominantly but can also occur in adults. However, due to a presumed good disease outcome, fatality rates of SVT in adults (above 25 years) are yet to be explored. Aim: This study aims to shed light on the mortality trends of SVT in the adult population across the United States from 1999 to 2020. Methodology: The CDC WONDER database was used to identify SVT-related deaths using ICD-10 code I47.2 in adults (above 25 years) from 1999 to 2020. The reported data was in the form of crude rate and age-adjusted mortality rate (AAMR) per 100,000 individuals and was stratified by year, ten-year age groups, gender, races, census region, census division, states, and rural-urban division. The Joinpoint regression was then used to determine the changes in trends and annual percentage change (APC). Results: From1999 to 2020, 31,036 (AAMR=0.6) SVT-related deaths were reported. AAMR showed an initial steep decline from 0.9 in 1999 to 0.5 in 2011 (APC -5.11 [95% CI -6.08 to -4.14]), followed by a gradual increase till 2020 (0.8) (APC 5.14 [95% CI 3.41 to 6.90]). The crude death rates increased with age and were reported to be highest in ages greater than or equal to 85 (9.1); the trend showed a steep decrease from 1999 (12.4) to 2008 (7.9) (APC -4.35 [95% CI -5.36 to -3.33]), followed by a gradual decline till 2017 (7.8) (APC -0.66 [95% CI -2.04 to 0.73]), and ultimately rising sharply till 2020 (10.6) (APC 9.23 {95% CI 3.32 to 15.47]). Among races, Blacks and Whites displayed the highest mortality (0.7). Blacks showed an initial decrement from 1999 (1.0) to 2017 (0.6) (APC -2.71), followed by a rise back to 1.0(2020) (APC 19.58), while whites showed an initial fall (0.9 (1999) to 0.6 (2008), APC -4.91), followed by no change till 2017 (APC 0.18), and ultimately rise to 0.9 in 2020 (APC 13.66). Although no significant gender or geographical variations were observed, more deaths were seen in rural areas (1.0) than in Urban (0.6). Conclusion: Following an initial decline, the incidence of SVT-related mortality has been increasing over the years, pre-dominantly among the 85+ age group, Blacks, and rural populations. However, due to a limited understanding of the epidemiology of SVT in adult populations, more extensive research is needed to formulate better preventive and management strategies.

Introduction: Few studies have investigated disease associated suicide other than mental health. We aimed to assess suicide mortality in cardiovascular disease. Methods: We used CDC WONDER to access National Vital Statistics System data from 1999 to 2019. Suicide and CVD related deaths in patients ≥ 25 years of age were identified from multiple causes of death. Proportionate suicide mortality (PSM) was calculated as number of suicide deaths listed with CVD, divided by number of all cardiovascular-related deaths irrespective of suicide, and reported as PSM per 100,000 cardiovascular deaths. Joinpoint regression was used to examine changes in trend using annual percentage change (APC) overall and by sex, race/ethnicity, disease subtype, and age. Results: PSM by disease category from most to least were mental health,, nervous system, musculoskeletal, gastrointestinal, cardiovascular, respiratory, and lastly malignant neoplasm. The CVD PSM increased from 62.8 in 1999 to 90.5 in 2019 (average APC 2.1* [95% CI, 0.2 to 3.9]). Notably, APC decreased from 2013-2019 (APC -2.1 (95% CI -3.6 to -0.5). In racial/ethnic groups, PSM was highest in non-Hispanic White (NHWs) (103.8) then Hispanic/Latino (H/L) (63.6), and lastly NH Black (NHB) (29.2) individuals. PSM was highest in 25-39 years age group (858) followed by 40-54 years (382.8), 55-69 years (146.2), 70-84 years (55.9), and lastly 85+ (17). APC in PSM initially increased in men (3.1 until 2013), women (4.1 until 2014), NHW (3.9 until 2013), H/L (3.5 until 2014), 40-54 (2.9 until 2013), 55-69 (6.0 until 2013) then either stabilized or decreased. While APC in NHBs (1.0) and 25-39 years (1.4) consistently increased till 2019. Conclusion: Among non-mutually exclusive disease categories, CVD ranked 3rd to last. PSM in CVD peaked in the early 2010s, with variable increases across various sex, racial/ethnic, and age groups. Further research is needed to understand the causes of these disparities to develop preventative strategies.

Mitral regurgitation (MR) is the second most common valvular heart disease in the United States with recent improvements in the management of MR including percutaneous therapies. However, MR-related mortality may vary across sex and race groups in the elderly population. Methods: We used CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) to access National Vital Statistics System data from 1999 to 2019. MR related deaths, age ≥75 years were identified from multiple causes of death and were represented as age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to examine changes in trend and annual percentage change (APC) overall and stratified by sex and race groups. Results: AAMR related to MR decreased from 29.0 in 1999 to 15.4 in 2012 and then increased to 16.4 in 2019 (2012-2019 APC 1.2 [95% CI, 0.5 to 2.0]). AAMR was higher in women (19.6) compared with men (18.6). Among the race groups, AAMR was highest in non-Hispanic whites (NHWs) (20.8) followed by non-Hispanics Others (NH Others) (includes American Indian or Alaska Natives and Asian or Pacific Islanders) (12.7), non-Hispanic blacks (NHBs) (10.5) and lastly Hispanics (10.1). AAMR was highest in NHW females (21.1). After an initial decline, APC in AAMR increased in both men (1.4) and women (1.0) since 2012 and NHWs (0.9) since 2011. AAMR decreased in NHBs (APC -5.0) till 2009 and Hispanics (APC -4.6) until 2013 and remained stable thereafter. APC in AAMR decreased in NH-Others (-1.9) during the entire study period. Conclusion: After initial decline, MR related mortality has been increasing recently. Significant disparities exist across various sex and race subgroups. Further studies are needed to understand these trends and address the underlying causes of the disparities and increasing mortality in this patient population.

BackgroundSyphilis notifications, including congenital syphilis, have increased markedly in recent years across the European Union/European Economic Area (EU/EEA), raising renewed public health concerns. This study aimed to characterise long-term trends in adult syphilis notifications in the EU/EEA from 2000 to 2023 and to examine recent patterns in congenital syphilis using joinpoint regression analysis.MethodsAnnual crude notification rates for adult syphilis (per 100,000 population, 2000-2023) and congenital syphilis (per 100,000 live births, 2010-2023) were obtained from the ECDC Surveillance Atlas. Joinpoint regression was applied to identify significant trend changes, estimate Annual Percent Change (APC) and, where appropriate, Average Annual Percent Change (AAPC).ResultsIn the EU/EEA, adult syphilis rates declined from 2000 to 2007 (APC -8.76%), increased from 2007 to 2021 (APC +3.32%), and rose sharply after 2021 (APC +24.65%). Overall AAPC (2000-2023) was +1.12%. Congenital syphilis rates declined between 2010 and 2016 (APC -11.92%), then increased between 2016 and 2023 (APC +9.16%).ConclusionsSyphilis notifications in the EU/EEA show a sustained resurgence, with recent acceleration and a parallel rising trend in congenital syphilis. Reinforcement of STI screening, timely treatment, and strengthened antenatal care are urgently warranted.

Simple SummaryThe incidence of esophageal cancer overall has increased in the United States, driven by increasing rates of esophageal adenocarcinoma (EAC). However, whether rates of EAC are still rising is unclear. We examined trends in esophageal cancer overall and within important sub-groups of the population. We found that esophageal squamous cell carcinoma (ESCC) rates have been steadily declining, while EAC rates rose rapidly before stabilizing in 2000. The trend of decreasing incidence of ESCC was observed almost uniformly by age group, sex, and race/ethnicity, while trends in EAC rates varied across these sub-groups. A cohort effect for EAC was observed among people born during 1950, but EAC rates were stable across successive generations born between 1950 and 1985. Given the continued rising rates of known EAC risk factors, including obesity and gastroesophageal reflux disease, there is a need to continue monitoring trends for changes in incidence rates.Background: Esophageal cancer (EC) incidence rates overall have declined in recent decades; however, the two main subtypes, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), show divergent secular trends. Methods: Age-adjusted EC incidence rates were calculated using data from the Surveillance Epidemiology and End Results (SEER) 12 Program. We examined secular trends from 1992 to 2019 overall and by age group, sex, race/ethnicity, tumor location, and SEER registry. Joinpoint regression was used to compute annual percent changes (APC) and average annual percent changes (AAPC). We used age-period-cohort models to examine the potential impact of period and birth cohort effects on trends. Results: Between 1992 and 2019, overall EC incidence rates declined by 0.54% annually (95% confidence interval [CI]: −0.75%, −0.33%). While ESCC rates declined linearly throughout the study period (AAPC = −2.85; 95%CI: −3.05%, −2.65%), EAC rates increased by over 5% annually from 1992 to 2000 (APC = 5.17; 95%CI: 3.28%, 7.10%), before stabilizing from 2000 to 2019 (APC = 0.22; 95%CI: −0.16%, 0.60%). Trends in ESCC and EAC varied by age group, sex, and race/ethnicity. Relative to ESCC rates among cohorts born circa 1950, the rates were 81% lower in cohorts born circa 1985 (rate ratio, 0.19; 95%CI: 0.04, 0.96). For EAC, rates have remained stable across successive birth cohorts since 1950. Conclusions: We observed linear declines in EC rates overall and for ESCC across age, sex, and race/ethnicity subgroups, but an inconsistent pattern for EAC. The trends in EAC cohorts born after 1955 were stable and suggest that EAC rates may have peaked in the U.S.

Reversal of declining cardiac mortality trends in hemolytic anemia: National evidence from 1999 to 2023

To analyze the trends of human schistosomiasis prevalence in Hubei Province from 2004 to 2018, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province. All data pertaining to human schistosomiasis prevalence in Hubei Province were collected from 2004 to 2018, and the trends for changes in seroprevalence, egg-positive rate and prevalence of human Schistosoma japonicum infection were analyzed using a Joinpoint regression model. Both of the numbers of residents seropositive and egg-positive for S. japonicum infections appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the prevalence of human S. japonicum infections reduced from 6.85% in 2004 to 0 in 2018. Joinpoint regression analysis showed that the prevalence of human S. japonicum infections appeared an overall tendency towards a reduction in Hubei Province from 2004 to 2018 [average annual percent change (AAPC) = -24.1%, P < 0.01], and the trends for the reduction were both significant during the period from 2004 to 2006 [annual percent change (APC) = -35.1%, P < 0.01] and from 2006 to 2018 (APC = -22.1%, P < 0.01). The prevalence of human S. japonicum infections appeared a tendency towards a decline in islet (AAPC = -25.1%, P < 0.01), inner embankment (AAPC = -26.4%, P < 0.01) and hilly subtypes of schistosomiasis-endemic areas (AAPC = -32.5%, P < 0.01) of Hubei Province from 2004 to 2018, and the prevalence all appeared a tendency towards a decline during the infection control stage (from 2004 to 2008), the transmission control stage (from 2009 to 2013) and the transmission interruption stage (from 2014 to 2018) (AAPC = -28.0%, -24.4% and -63.8%, all P values < 0.01). The seroprevalence of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = -14.5%, P < 0.01), and the trends for the reduction were both significant during the period from 2004 to 2012 (APC = -8.4%, P < 0.01) and from 2012 to 2018 (APC = -22.1%, P < 0.01). In addition, the egg-positive rate of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = -30.6%, P < 0.05), and the trend for the reduction was significant during the period from 2007 to 2014 (APC = -15.5%, P < 0.01). The prevalence of human schistosomiasis appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the islet and inner embankment subtypes of endemic areas are a high priority for schistosomiasis control during the stage moving towards elimination in Hubei Province.

1535 Background: Leukemia, a hematologic malignancy, often coexists with cardiovascular disease (CVD), worsening outcomes due to shared risk factors like diabetes, hypertension, and smoking. Despite CVD's known impact on leukemia mortality, research on demographic and geographic disparities remains limited. This study examines disparities in the Reporting Odds Ratio (ROR) of CVD burden among leukemia deaths across age, gender, place of death, and race/ethnicity using CDC WONDER data (1999–2020). Methods: A disproportionality analysis of CDC WONDER death certificate data for U.S. adults (15–85) was conducted. Records were grouped into four variables: leukemia deaths with CVD (A), leukemia deaths (B), CVD deaths (C), and all deaths (D). RORs were calculated as (A/B) / (C/D) and stratified by gender, race/ethnicity, urbanization, and place of death. Age groups were categorized into 15–24, 25–64, and 65+ years. Joinpoint regression was used to compute annual percentage change (APC) and average annual percentage change (AAPC) to identify trends. Results: Analysis of 22 years of data revealed disparities in RORs across demographics. The 15–24 age group had the highest ROR for males (2.51) and females (1.59), indicating a greater CVD burden in leukemia deaths than all-cause mortality. Middle-aged (25–64) and older adults (65+) had lower RORs (&lt;1), suggesting a reduced CVD-leukemia burden in these groups. Trends: The young female cohort showed a sharp ROR decline (2018–2020, APC: -22.02%; 95% CI -36.00 to -1.23; p=0.039), while the elderly male cohort (85+) had a steady rise (APC: 6.93%; 95% CI 1.74–9.24; p&lt;0.0001). Place of Death: Medical facilities had the highest CVD burden in leukemia deaths, especially in younger cohorts (15–24; ROR: 1.47). Hospice facilities had the lowest RORs across age groups. The "Other/Unknown" category had an outlier ROR of 4.81 in the youngest cohort, suggesting data limitations. Race/Ethnicity: Hispanics had the highest ROR (2.64) in the 15–24 age group, followed by Asians (2.21). In middle and older age groups, RORs declined for all races. Hispanics (65–74) showed an increasing ROR trend (AAPC: 0.92%; 95% CI 0.45–1.36; p=0.002). Conclusions: Significant disparities exist in CVD burden among leukemia deaths, with younger cohorts, males, Hispanics, and patients in medical facilities showing the highest RORs. These findings highlight the need for targeted cardio-oncology strategies to address CVD risk in leukemia patients. Further research on chemotherapy-related cardiotoxicity and healthcare disparities is crucial to reducing inequities and improving outcomes.