Cancer and intracerebral hemorrhage-related mortality in the United States: A nationwide retrospective study (1999-2023).

BACKGROUND

Cancer patients with improved survival rates have been paradoxically linked with increased age-associated comorbidities, including Intracerebral Hemorrhage (ICH). Although ICH mortality remains high in cancer patients due to coagulopathy and systemic inflammation, nationwide long-term mortality trends remain understudied. We aim to analyze co-occurring ICH and cancer-associated mortality trends and disparities in the United States.

METHODS

Death certificate information was analyzed using the CDC WONDER database (1999-2023), considering adults (aged ≥35 years) listing cancer and ICH as underlying or contributing causes of death. Age-Adjusted Mortality Rates (AAMRs) per 1,000,000 were calculated and standardized to the 2000 U S.

POPULATION: Joinpoint regression was utilized to assess temporal trends and calculate Annual Percent Changes (APCs).

RESULTS

Overall, 42,103 deaths occurred, and the AAMR declined significantly from 1999 to 2015 and reversed to a significant increase thereafter (APC 1.86*; 95% CI: 1.19-2.78; p = 0.008798). Males exhibited approximately 1.5 times the average mortality rate of females (12.2 vs. 7.8). Among racial/ethnic groups, Non-Hispanic (NH) African Americans (10.2) bore the highest mortality burden. Geographically, the Midwest region (10.2) and non-metropolitan areas (10.4) reported higher mortality rates compared to their counterparts.

CONCLUSIONS

ICH and cancer-related mortality have risen since 2015 following a period of decline, with persistent disparities affecting males, NH African Americans, and non-metropolitan populations. These findings highlight the urgent need for prospective clinical registries to further investigate overlapping cardiovascular and metabolic risk factors within these vulnerable oncology populations.