e23361 Background: Malignant genital neoplasms in both men and women markedly elevate mortality risk, as tumor progression and reproductive organ compromise intensify systemic vulnerability. This study aims to analyze and interpret trends, geographic variations, and disparities among men and women in the United States. Methods: The mortality data from the CDC WONDER multiple cause of death files for all ages were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 100,000 through ICD-10 Codes: C51–C58 for female genital cancer and ICD-10 Codes: C60–C63.9 for male genital cancer, stratified by year, gender, race/ethnicity, place of death and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: A total of 1,907,686 deaths were attributed to patients with malignant genital neoplasms (females: 812,497; males: 1,095,189), with most occurring at the decedent's home (40.76%). The overall AAMR declined from 27.48 in 1999 to 20.64 in 2023 (AAPC: –1.22; 95% CI: –1.51 to –0.93; p < 0.000001), with a significant decline observed between 1999–2013 (APC: –2.15; p < 0.000001), followed by a significant rise between 2018–2021 (APC: 2.39; p = 0.019). Men had higher AAMR (33.03 vs 17.07), but the decline in mortality was more pronounced than among women (AAPC: –2.08 vs –0.55). Older adults aged ≥65 years had the highest CMR among other age groups (201.55). By race, the highest AAMR was noted among non-Hispanic (NH) Blacks (35.69), while the lowest was among NH Asians (11.76). Geographic disparities were evident, with the Midwest having the highest AAMR and the South having the lowest (22.94 vs 22.11). Non-metropolitan areas showed higher AAMR than metropolitan areas (23.77 vs 22.46). A steeper decline in mortality was seen in metropolitan areas compared to non-metropolitan areas (AAPC: -1.45 vs -1.38). At the state level, the District of Columbia ranked highest, placed in the top 90th percentile from 1999 to 2023. Conclusions: Mortality from malignant genital neoplasms has declined over the past two decades, with a disproportionate impact on older adults, men, NH Blacks, and the population of non-metropolitan and Midwest regions. Targeted interventions and equitable access to healthcare are needed to reduce mortality and address persistent health inequities among vulnerable populations. Average annual percent change (AAPC) of age-adjusted mortality rates for malignant genital neoplasms in the United States, 1999 to 2023. Variable Deaths AAPC (95%CI) Overall 1,907,686 -1.22 (-1.51 to -0.93) Male 1,095,189 -2.08 (-2.50 to -1.66) Female 812,497 -0.55 (-0.70 to -0.40) Non-metropolitan areas 303,668 -1.38 (-1.63 to -1.13) Metropolitan areas 1,340,710 -1.45 (-1.62 to -1.29)
Khan et al. (Thu,) studied this question.