Trends in mortality caused by neoplasms of the heart in the United States between 2000 and 2019: An observational analysis of disparities by gender and race.

Abstract

10532 Background: Neoplasms of the heart, primary and metastatic, are relatively rare diseases in the US. Metastatic neoplasms are 30 times more common than primary neoplasms and constitute more than 99.3% of the total neoplasms of the heart. Only a few studies have evaluated the mortality trends of this rare disease. Therefore, we aim to analyze the trends of mortality caused by benign and malignant neoplasms of the heart from 2000-2019 and compare them based on gender and race. Methods: We utilized the CDC WONDER database to extract data on Heart Benign Neoplasms (ICD 10 D15.1), Heart Malignant Neoplasms (C38.0), and overlapping lesions of Heart, Mediastinum, and pleura (C38.8) mortality in the United States between 2000 to 2019. ICD codes were applied to multiple causes of death. Age-standardized mortality rates (ASMR) per 1,000,000 with a 95% confidence interval were presented for the total population, stratified by gender and race. We assessed the mortality trends using joinpoint trend analysis. Results: From 2000 to 2019, 3493 deaths were reported due to neoplasms of the heart, out of which 1672 (47.86%) were due to benign neoplasms, and 1821 (52.13%) were due to malignant neoplasms. Overall, total deaths and ASMR decreased from 221 to 139 and 0.82 to 0.35, respectively, with an Average Annual Percentage change (AAPC) of -3.5. Out of 3493, the majority were females (2254, 64.5%). On evaluating ASMR based on gender, it decreased from 0.65 to 0.32 (AAPC -2.6) for males and from 0.89 to 0.35 for females (AAPC -3.9). On dividing based on racial subgroups, 2962 deaths were in whites, 413 were in African Americans (AA), and 118 were from other races (Asian, Pacific Islanders, Native Indians). On further comparison between Whites and AA, ASMR was found to be higher in AA throughout the study period. For AA, ASMR decreased from 1.18 to 0.51 (AAPC -4.9), and for Whites, from 0.76 to 0.33 (AAPC -2.5). Conclusions: This study has shown a decline in overall mortality trends across genders and races. This could be attributed to increased cardiac workups for cardiovascular conditions and advances in imaging modalities, cardiac oncology, and therapeutic interventions. Although the mortality trend in females is decreasing, they still have higher mortality rates than males. At the same time, although AA showed a higher rate of reduction in ASMR, they showed an overall higher ASMR throughout the study period. Further studies are needed to assess if increased screening, early detection, and management plans are causing a decrease in overall mortality in neoplasms of the heart. [Table: see text]