Demographic trends and geographic disparities in malignant neoplasm of eye and adnexa-related mortality in the United States, 1999-2023.

BACKGROUND

Mortality patterns for malignant neoplasms of the eye and adnexa remain under-described at the national scale.

METHODS

Using CDC WONDER (1999-2023), we identified U.S. decedents aged ≥25 years with ICD-10 C69 as the underlying cause. Age-adjusted mortality rates (AAMR; per 100,000, 2000 U.S. standard) and trends were assessed with Joinpoint regression; analyses were stratified by sex, age, census region, urbanisation, place of death, and education.

RESULTS

National AAMR rose from 0.12 (95% CI: 0.10-0.14) in 1999 to 0.16 (0.14-0.17) in 2023 (peak 2021), yielding a significant monotonic increase. (Annual percent change, APC, +1.34%; 95% CI: 0.92-1.76; p < 0.001). Male AAMR exceeded female AAMR, but the relative rise was steeper in females (APC 1.80% vs. 1.16%). Regional disparities were pronounced (West highest, Northeast lowest), with a post-2016 acceleration in the South. Metropolitan areas showed a modest but significant increase; nonmetropolitan trends were volatile and not statistically significant. From 1999 to 2020, home and hospice deaths increased while hospital deaths were comparatively stable. Education-related differences narrowed slightly in 2021-2023 but remain uncertain. State-level estimates were sparse and unstable due to suppression.

CONCLUSIONS

U.S. mortality from ocular and adnexal cancers increased modestly over 1999-2023 with persistent sex, regional, and urban-rural disparities. Findings support registry linkages and targeted prevention, referral, and palliative strategies, and offer a suppression-aware template for international surveillance.