Longitudinal overview of mortality for malignant neoplasm of the brain and cerebrovascular diseases in the U.S. from 1999 to 2023 using CDC WONDER.

Abstract

e14024 Background: Malignant brain tumors and cerebrovascular diseases are major contributors to mortality in the United States. Brain tumors are associated with poor survival, while cerebrovascular disease, including stroke, remains a leading cause of death. Characterizing long-term mortality trends for these conditions may inform prevention strategies, clinical care, and public health planning. Methods: We conducted a retrospective population-based study using CDC WONDER multiple-cause-of-death data from 1999–2023. Deaths with malignant neoplasm of the brain (ICD-10 C71) and cerebrovascular disease (ICD-10 I60–I69) listed as underlying or contributing causes were identified among individuals aged 25–85+ years. Analyses followed STROBE guidelines. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Trends were stratified by age, sex, race/ethnicity, census region, and urbanization. Joinpoint regression (version 5.4.0) was used to estimate annual percent change (APC) with 95% confidence intervals. Results: From 1999 to 2023, 16,062 deaths were identified (9,062 males [56.41%], 7,000 females [43.58%]). Overall AAMR increased from 0.27 to 0.38, with higher rates in males (0.33→0.48) than females (0.24→0.29). By race/ethnicity, Whites had the highest AAMRs (0.28→0.44), while Black/African American individuals had the lowest (0.17→0.26). The largest number of deaths occurred in the South (5,877), followed by the West (3,988), Midwest (3,722), and Northeast (2,475). Mortality declined from 1999–2007 (APC −2.55%, 95% CI −4.44 to −0.63; p=0.012) and subsequently increased from 2007–2023 (APC 2.68%, 95% CI 2.06–3.31; p<0.000001). Conclusions: Mortality associated with malignant brain neoplasms and cerebrovascular disease shifted from early decline to sustained increases after 2007, with higher burden among males, older adults, and residents of the South and Midwest. These findings underscore the importance of integrated neuro-oncology and cerebrovascular risk management strategies and targeted public health interventions to address emerging disparities.