Trends in mortality due to myelodysplastic syndromes from 1999 to 2020: A CDC WONDER analysis.

Abstract

e22568 Background: Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic disorders with ineffective blood cell production causing cytopenias, dysplasias, and ineffective hematopoiesis. With an estimated global incidence of 4.8 per 100,000 people per year, MDS poses a substantial burden on healthcare systems and affects the quality of life of patients worldwide. This study aims to analyze trends in mortality due to MDS in the United States from 1999 to 2020 using CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) data. Methods: In this study, we conducted an in-depth search of the CDC Wonder database using the Age-Adjusted Mortality Rate (AAMR) per 1000,000 individuals as the basis for the incidence of MDS-related deaths. ICD-10 code D46.9 was used to assign Myelodysplastic Syndromes as the contributing cause of death. We evaluated parallelism using Join Point Regression Analysis and calculated Annual Percent Changes (APC) with a 95% Confidence Interval. The parallelism test was considered significant for unparallel if the p-value was less than 0.05. Results: The total number of deaths reported from 1999-2020 due to MDS was 223,505. Although there has been an overall decline in age-adjusted rates over the past 21 years with an Average Annual Percent Change (AAPC) of -0.27% (95% CI: -0.78% to 0.24%; p = 0.292), there was a significant increase in rates from 2004 to 2010 with an Annual Percent Change (APC) of 2.46% (95% CI: 1.08% to 3.85%; p = 0.002), followed by a significant decline from 2010 to 2020 with an APC of -2.20% (95% CI: -2.63% to -1.77%; p < 0.001). Males showed a more significant decrease in mortality rate with an AAPC of -0.51% (95% CI: -0.75% to -0.27%; p < 0.001) compared to -0.38% (95% CI: -0.85% to -0.09%; p = 0.1166) in females. The Midwest region showed the greatest short-term decrease in mortality from 2014-2018 with an APC of -4.0907%. On the other hand, the West region showed the greatest overall decrease in mortality with an AAPC of -0.7677%. Of all the races, Asian or Pacific Islander group showed the greatest short-term decrease in mortality with an APC of -3.2538% (2010-2020). South Dakota experienced the greatest mortality among all the states in the USA. Upon further analysis, the Large Central Metro group showed greatest decrease in mortality with APC of -1.00% (p = 0.049513) as compared to other urbanized cohorts. Conclusions: Mortality trends due to MDS in the U.S. from 1999 to 2020 revealed a dynamic pattern, with an initial rise followed by a sustained decline, reflecting shifting healthcare advancements and regional disparities in outcomes.