Abstract
Cutaneous and Peripheral T-cell Lymphomas in the U.S. population: A 25-Year National Review of Epidemiological Burden and Racial Disparities Introduction: Peripheral and cutaneous T-cell lymphomas are rare, aggressive cancers with rising global burden. In the US population, they pose an increasing concern among elder people. This study aims to identify the demographic and regional disparities in peripheral and cutaneous T-cell lymphomas-related mortality in the U.S. from 1999 to 2023.
Methodology: Data were retrieved from the CDC WONDER single cause-of-death database for the years 1999 to 2023, including individuals aged ≥45 years with a primary cause of death due to peripheral and cutaneous T-cell lymphomas (ICD-10 codes: C84). We assessed age-adjusted mortality rates (AAMRs) per 100,000. Trends in age-adjusted mortality rates (AAMR) were assessed based on socio-demographic and regional variables using Joinpoint Regression (JPR) analysis. Annual percentage change (APC) with 95% confidence intervals (CIs) for the AAMRs were calculated for the line segments linking a Joinpoint using a data-driven weighted Bayesian Information Criterion (BIC) model.
Results: From 1999 to 2023; Peripheral and cutaneous T-cell lymphomas accounted for 25,768 deaths occurred among U.S. adults aged ≥45 years. The overall AAMR was 0.83 (95% CI: 0.81–0.85). Annual analysis showed an increasing trend from 1999 to 2016 (APC: 2.50%, 95% CI: 1.93–6.38, p = 0.0012). Males accounted for 60.03% of total deaths, compared to 39.97% of females. From 1999 to 2005, female showed sharp rise in mortality (APC: 6.31%, 95% CI: 2.71–19.8, p=0.00). Among the racial groups, from 2001 to 2014, Asian showed significant increase in mortality trends (APC: 3.86%, 95% CI: 1.85–12.5, p=0.00). Hispanic populations experienced a sharp rise from 1999 to 2006 (APC: 8.57%, 95% CI: 2.29–32.98, p < 0.001). Regionally, the highest AAMRs were observed in Census Region 1: Northeast, which showed a significant increase from 1999 to 2002 (APC: 17.8%, 95% CI: 3.72–50.3, p=0.00). According to 2013-urbanization framework, large central metro areas showed the significant incline from 1999 to 2009 (APC: 4.30%, 95% CI: 2.83 to 8.78, p=0.00). District of Columbia had highest AAMR of 1.2.
Conclusion: An Initial incline followed by an abrupt decline in mortality rates suggests substantial betterment through active management strategies and robust healthcare policies. However, notable disparities among male, Hispanic, and African American populations highlight the need for targeted interventions in order to improve clinical outcomes.
