National mortality trends of malignant melanoma associated with cerebrovascular diseases in the United States (1999-2023).

e21518 Background: Malignant melanoma and cerebrovascular diseases (CVDs) pose major U.S. public health burdens, with melanoma mortality of 2.0–2.7 per 100,000 and > 160,000 annual cerebrovascular deaths. Linked through hypercoagulability, vascular disruption, and frequent brain metastases in advanced melanoma, their combined mortality patterns remain poorly defined despite therapeutic advances. This study examines national trends from 1999 to 2023 to identify vulnerable populations that require targeted interventions. Methods: This population-based study analyzed U.S. mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs) were calculated for malignant melanoma (ICD-10 C43) associated with cerebrovascular diseases (ICD-10 I60–I69) among decedents aged ≥45 years from 1999 to 2023. Trends were stratified by age, sex, race/ethnicity, urbanization, and Census region using Joinpoint regression. Analyses were conducted between December 2025 and January 2026. Results: Nationally, melanoma-associated cerebrovascular mortality increased by 1.4% annually from 1999 to 2023 (P < .05). Rates rose more steeply among individuals aged ≥65 years (AAPC, 1.59%; post-2012 APC, 3.46%; P < .001) compared with those aged 45–64 years. Non-Hispanic White individuals experienced the largest increase (AAPC, 2.8%; post-2018 APC, 6.5%; P < .001). Mortality rates were higher among males than females, though trends were parallel. Nonmetropolitan areas (AAPC, 2.05%) and the South and Midwest showed faster increases than metropolitan, Northeastern, or Western regions. Conclusions: Despite overall declines in isolated melanoma and cerebrovascular mortality, combined melanoma-associated cerebrovascular deaths increased steadily over two decades. Older adults, non-Hispanic White individuals, men, rural residents, and populations in the South and Midwest bear a disproportionate burden. These findings highlight the need for integrated vascular-oncologic care, enhanced surveillance, and equitable access to advanced therapies. Age-adjusted mortality trends for melanoma-related cerebrovascular deaths in U.S. adults ≥45 years (1999–2023). S. No. Characteristic AAMR (1999-2023) AAPC (95%CI) P Value JP, No. 1. Overall 0.30-0.40 1.37 (0.92–1.81) <0.001 1 2. Female 0.21-0.26 1.13 (0.22–2.05) 0.023 1 3. Male 0.50-0.60 1.38 (0.88–1.88) 0.000 1 4. Hispanic 0.31-0.45 1.50 (1.01–1.99) 0.000 1 5. Non-Hispanic - White 0.37-0.54 1.59 (1.12–2.06) 0.000 1 6. 45-64 years 0.10-0.14 1.07 (0.04–2.10) 0.053 0 7. ≥65 years 0.66-0.87 1.52 (1.05–1.99) 0.000 1 8. Census Region- Midwest 0.21-0.42 1.97 (1.12–2.82) 0.000 1 9. Census Region- West 0.38-0.48 1.45 (0.72–2.19) 0.001 1