Cancer epidemiology · 2025
Temporal trends in AML incidence and mortality, with a focus on AML-related deaths among patients with myelodysplastic syndromes in the United States, 1999-2023.
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Akoto Natalie A, Orhin Albert E, Chukwu Denise Eke, Gyato Albert, Egyin Simon, Idun Maame Yaa, Aninkora Kwabena Owusu
Аннотация
BACKGROUND: Myelodysplastic syndromes (MDS) are bone marrow disorders that often affect older adults and can lead to acute myeloid leukemia (AML), a more aggressive cancer. While this progression is well known, national trends in AML-related deaths, specifically among patients with MDS, have not been well described.
METHODS: Using CDC WONDER death certificate data from 1999 to 2023, we identified adults aged 25 years and above who died from AML with MDS listed as a contributing cause. We analyzed demographics, place of death, and trends over time. Age-adjusted mortality rates were calculated and stratified by sex, race, geography, and urbanization. We also examined national trends in AML incidence and mortality-to-incidence ratios (MIR).
RESULTS: AML incidence was 5.8 per 100,000, rising slightly over time (AAPC + 0.5 %; 95 % CI: 0.25-0.70). Among 16,979 AML-related deaths in people with MDS, most were male (61.6 %), White (91.8 %), and aged ≥ 75 years. Nearly half died in hospitals, while < 1 % underwent autopsies. The age-adjusted mortality rate was 0.5 per 100,000 in males and 0.2 in females (p < 0.0001). Mortality declined overall (AAPC - 1.16 %; 95 % CI: - 1.75 to - 0.57), with the sharpest drop between 2021 and 2023 (APC - 17.12 %, 95 % CI: - 22.61 to - 9.20). Improvements were most notable in urban areas and among White patients.
CONCLUSION: AML-related mortality in MDS patients has declined over the past 25 years, likely reflecting progress in treatment and supportive care. However, disparities persist. More equitable access to advanced therapies is needed to ensure all patients benefit from recent advances.
METHODS: Using CDC WONDER death certificate data from 1999 to 2023, we identified adults aged 25 years and above who died from AML with MDS listed as a contributing cause. We analyzed demographics, place of death, and trends over time. Age-adjusted mortality rates were calculated and stratified by sex, race, geography, and urbanization. We also examined national trends in AML incidence and mortality-to-incidence ratios (MIR).
RESULTS: AML incidence was 5.8 per 100,000, rising slightly over time (AAPC + 0.5 %; 95 % CI: 0.25-0.70). Among 16,979 AML-related deaths in people with MDS, most were male (61.6 %), White (91.8 %), and aged ≥ 75 years. Nearly half died in hospitals, while < 1 % underwent autopsies. The age-adjusted mortality rate was 0.5 per 100,000 in males and 0.2 in females (p < 0.0001). Mortality declined overall (AAPC - 1.16 %; 95 % CI: - 1.75 to - 0.57), with the sharpest drop between 2021 and 2023 (APC - 17.12 %, 95 % CI: - 22.61 to - 9.20). Improvements were most notable in urban areas and among White patients.
CONCLUSION: AML-related mortality in MDS patients has declined over the past 25 years, likely reflecting progress in treatment and supportive care. However, disparities persist. More equitable access to advanced therapies is needed to ensure all patients benefit from recent advances.