Demographic and regional trends in cardiovascular disease and Hodgkin lymphoma–related mortality in the United States: A CDC WONDER perspective (1999-2020).

Abstract

e19039 Background: Cardiovascular diseases (CVDs) are significant and burdensome complications of Hodgkin lymphoma (HL), contributing to increased mortality and morbidity. This study analyzed mortality trends and disparities due to HL and CVD among adults aged 25 and older from 1999to 2020. Methods: Using ICD-10 Codes C81 (Hodgkin Disease) AND I00-199 (Diseases of the circulatory system, crude and age-adjusted mortality rates (AAMR) per million were extracted from CDC WONDER and analysed across variables such as gender, race/ethnicity, year, state, census region, urbanization and place of death. Joinpoint regression software was employed to calculate the annual percent change (APC) and average annual percent change (AAPC). Results: A total of 12807 deaths were reported throughout the study period. The overall AAMR decreased from 3.35 in 1999 to 2.81 in 2020 with an AAPC of -0.75 (95% CI, -1.47 to -0.40). A significant decrease occurred from 1999 to 2018 ( APC: -1.61; 95% CI: -2.73 to -1.19), followed by a non-significant increase from 2018 to 2020 (APC: 7.83; 95% CI, -0.92 to 11.93). The AAMR for males was higher than for females (3.52 vs. 2.13), with a slower rate of decline for males (AAPC: -0.63) compared to females (AAPC: -1.32). Non-Hispanic (NH) White had the highest AAMR (2.89) followed by Hispanic (2.69), NH Black (2.30), NH American Indian (1.60), and lastly NH Asian (1.10). Among the US regions, the Northeast census region had the highest AAMR (3.20), followed by the West (2.95), Midwest (2.65), and lastly the South census region (2.35). Rural areas showed higher AAMR (2.83) than the urban areas (2.70). Rhode Island had the highest AAMR of 4.37. 56.27% of all fatalities occurred in medical facilities. Conclusions: Our analysis revealed notable discrepancies across age, sex, urbanization, race, and states in the United States, with an increase in mortality rate observed in the recent years. The stark differences in death rates by geography and demographics highlight a dire need for concentrated research and equitable distribution of resources. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for Hodgkin lymphoma and cardiovascular disease among adults in the United States between 1999 and 2020. Variable Variable Deatds (n) Total AAMR (95% CI) Deatds (n) Total AAMR (95% CI) Overall 12807 3.11 (3.08 to 3.14) Urbanization Sex Urban 10568 2.70 (2.65 to 2.75)  Female 5486 2.35 (2.32 to 2.38) Rural 2239 2.83 (2.71 to 2.95)  Male 7321 4.14 (4.09 to 4.19) Race/Ethnicity Census Region NH American Indians 44 1.60 (1.14 to 2.18)  Northeast 2881 3.20 (3.08 to 3.32) NH Asians 207 1.10 (0.94 to 1.25)  Midwest 2816 2.65 (2.55 to 2.75) NH Blacks 1122 2.30 (2.16 to 2.44)  South 4053 2.35 (2.28 to 2.42) NH White 10347 2.89 (2.84 to 2.95)  West 3057 2.95 (2.84 to 3.05) Hispanics 1053 2.69 (2.52 to 2.86)