Changes in price, income and e-cigarette affordability for young people in the USA from 2015 to 2021

Introduction: Lower gastrointestinal (GI) cancers, including jejunal, ileal, colorectal and anal malignancies, remain among the most prevalent cancers in the United States. According to data from the Internal Agency for Research on Cancer (IARC), lower GI cancers accounted for roughly 10% of newly diagnosed cancers and over 9% of all cancer mortality in adults in 2022. However, trends in lower GI cancer mortality vary by geographic region and race. Understanding these disparities can support equitable cancer prevention strategies and targeted public health interventions. Methods: Age-adjusted mortality rates from 1999 to 2020 were extracted from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database and analyzed using Joinpoint regression to identify temporal changes in lower GI cancer mortality by U.S. Census region and racial/ethnic group. Lower GI cancers were defined using ICD-10 codes C17.1-C21, which included all malignant neoplasms from the jejunum to the anus. Annual percent change (APC) and average annual percent change (AAPC) were calculated and Age-Adjusted mortality rates were compared, with statistical significance set at p < 0.05. Results: All four census regions demonstrated statistically significant declines in lower GI cancer mortality over the study period. The steepest average decline was observed in the Northeast (AAPC = -3.06%, 95% CI: -3.54 to -2.57; p < 0.0001), followed by the Midwest (-2.32%, 95% CI: -2.46 to -2.17), West (-2.05%, 95% CI: -2.23 to -1.87), and South (-2.01%, 95% CI: -2.17 to -1.84). Significant declines in mortality rates were also seen across all racial and ethnic groups. The largest decrease occurred among Black or African American individuals (AAPC = -2.70%, 95% CI: -2.88 to -2.53), followed by White individuals (AAPC = -2.13%), Asian or Pacific Islander (-1.92%), Hispanic or Latino (-1.58%), and American Indian or Alaska Native (-1.67%). The White cohort exhibited multiple Joinpoints, with an initial sharp decline between 2002–2005 (APC = -3.70%), followed by a continued decline through 2020. However, despite statistically significant decreases in lower GI cancer mortality rates during the observed time-period, Black or African American mortality rates were significantly higher than those in all other races. Conclusions: Lower GI cancer mortality has declined significantly across racial and regional lines in the United States, though the magnitude of reduction varies. Northeastern states and Black individuals experienced the steepest improvements; however Black or African American populations have persistent and significantly increased mortality rates than all other races. Continued focus on early detection, racial, and region-specific public health initiatives is essential to sustain and enhance these positive trends, particularly in regions or groups with slower declines and persistently higher mortality rates. Citation Format: Shefali Khanna, FNU Rashi, Muhammad Ahmed, Bianca Mannariat, Jonathan Lopez. Trends in lower gastrointestinal cancer mortality across racial and regional groups in the United States: A CDC WONDER and Joinpoint trend analysis, 1999–2020 [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C008.

Trends in comorbid mortality from disseminated intravascular coagulation and sepsis in United States adults: A population-based analysis using CDC wonder database

Acute Myeloid Leukemia and sepsis-related mortality in the United States (U.S.) older adults: Nationwide trends and disparities over 25 years (1999 – 2023)

Objective: To analyze the level and trend of respiratory disease mortality in China from 2002 to 2016. Methods: The standardized mortality rates were calculated based on the China health statistics yearbook (2003-2012) and China statistical yearbook of health and family planning (2013-2017) data released by the statistical information center of National health Commission of the People's Republic of China. Joinpoint model was used to calculate the standardized mortality rates (SMR), Annual percentage change (APC) and the average annual percentage change (AAPC) for standardized mortality rates. Results: The SMR of respiratory diseases and chronic lower respiratory diseases were decreased significantly in 2002 to 2016 (AAPC=-3.6%, AAPC=-6.4%, P<0.001, respectively). The SMR of lung cancer showed a significant increase trend (AAPC=1.6%, P=0.001). There were no significant differences in the SMR of pneumonia and pneumonoconiosis (APCC=1.0%, P=0.242; APCC=-0.2%, P=0.905). Both urban and rural SMR of respiratory diseases were declining significantly (AAPC=-2.9%, P=0.001; AAPC=-4.2%, P<0.001). Both urban and rural SMR of lung cancer showed an increasing trend (AAPC=0.6%, P=0.022; AAPC=2.1%, P=0.003, respectively). The SMR of pneumonia in urban areas showed an upward trend (AAPC=2.7%, P=0.017). The SMR of respiratory disease of all age groups (<35 years old, 35-65 years old and ≥65 years old) showed a downward trend (AAPC=-3.8%, P=0.001; AAPC=-2.6%, P<0.001; AAPC=-3.9%, P<0.001). The SMR of pneumonia between 35 and 65 years old and SMR of lung cancer over 65 years old showed an increasing trend (AAPC=2.8%, P=0.001; AAPC=2.4%, P<0.001). The SMR of respiratory diseases among males and females showed a downtrend (AAPC=-3.1%, P<0.001; AAPC=-4.3%, P<0.001). However, the SMR of lung cancer in males and females increased significantly (AAPC=1.2%, P<0.001; AAPC=2.5%, P<0.001, respectively). There were no significant trends in the SMR of pneumonia and pneumoconiosis in males (AAPC=1.5%, P=0.096; AAPC=-1.6%, P=0.218). There was no obvious trend in the SMR of pneumonia in females (AAPC=-0.1%, P=0.872). Conclusions: The SMR of respiratory diseases in China generally shows a downward trend. The overall SMR and SMR of major respiratory diseases varies among different regions, genders and age groups.

Acute Myocardial Infarction (AMI) in malignancy is a global threat, causing significant mortality and economic burden. They share common risk factors, highlighting the urgency of addressing this critical issue. This study analyzed demographic trends and disparities in mortality rates due to AMI in malignancy among adults aged 65 and older from 1999 to 2020. We used the CDC WONDER database to analyze Age-adjusted mortality rates (AAMRs) for AMI in malignancy patients (ICD-10 I21, C00-C97) from 1999 to 2020, stratifying by sex, race, geography, and metropolitan status. We calculated Average Annual Percentage Changes (AAPCs) and Annual Percentage Changes (APCs) per 100,000 with 95% confidence intervals (CI) using Joinpoint regression. Between 1999 and 2020, AMI in malignancy accounted for 172,691 deaths among adults aged ≥65 years, with the majority of deaths occurring in medical facilities (56.9%). The overall AAMR for AMI in malignancy-related deaths decreased from 30.2 in 1999 to 14.2 in 2020, with an AAPC of -3.90 (p<0.000001). Men showed higher AAMRs than women (28.6 vs. 12.3), with a more pronounced decrease in men (AAPC: 4.22, p<0.000001) compared to women (AAPC: 3.78, p<0.000001). Black individuals have the highest AAMR (22.7), followed by Whites (19.3). Arkansas had the highest AAMR (32.3), while Nevada had the lowest (8.1), with the Northeastern region having the highest regional AAMR (20.2), and nonmetropolitan areas had higher AAMRs. This study reveals significant demographic disparities in mortality rates related to AMI in malignant older adults. These findings emphasize the need for targeted interventions and improved access to care.

Purpose: This study analyzes global trends in age-standardized IHD mortality from 1990 to 2021 across Socio-Demographic Index (SDI) groups to assess income-based disparities. Methods: GBD data was analysed to assess the mortality rates for IHD from 1990 to 2021 across five SDI groups. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were calculated to determine mortality rate trends over time, with p-values determining the statistical significance. Results: Global age-standardized IHD mortality declined by 30%, from 158.9 per 100,000 in 1990 to 111.5 in 2021, highlighting a significant three-decade reduction. The AAPC was -1.30% (CI: -1.34 to -1.26) with a highly significant p-value, indicating a clear decreasing trend. In low SDI regions, IHD mortality declined by 9.4% from 1990 to 2021. From 1990–2013, the decline was slow (APC = -0.20%, 95% CI: -0.30 to -0.09), but from 2014–2021, it accelerated (APC = -1.13%, 95% CI: -1.57 to -0.68). The overall trend shows no significant change (AAPC = 0.01, CI: -0.10 to 0.11). In low-middle SDI regions, mortality decreased by 13%. From 2014–2021, a moderate decline was observed (APC = -0.64%, 95% CI: -1.00 to -0.26). However, overall, there was a slight but significant increase (AAPC = 0.16, CI: 0.09 to 0.23). In middle SDI regions, mortality declined by 11%. From 2011–2021, the trend showed a steady decrease (APC = -0.78%, 95% CI: -0.99 to -0.56). Overall, a small but significant decline was observed (AAPC = -0.12, CI: -0.19 to -0.04). In high-middle SDI regions, mortality dropped by 26%. From 1990–2006, the decline was slow (APC = -0.33%, 95% CI: -0.58 to -0.07), but from 2007–2021, the decline accelerated sharply (APC = -2.41%, 95% CI: -2.77 to -2.05). The overall trend shows a significant decrease (AAPC = -1.56, CI: -1.77 to -1.36). In high SDI regions, mortality fell by 49%. Conclusions: IHD mortality has declined globally, with high-income regions achieving the earliest and steepest reductions, though progress has slowed. Low- and middle-income regions saw slower improvements initially but experienced a faster decline in the 2010s. High-middle SDI regions showed the most significant improvement after 2007, driven by economic growth and healthcare advancements. Despite progress, sustained efforts are needed for equitable cardiovascular care.

To evaluate the effectiveness of the integrated schistosomiasis control programme in Wuhan City from 2005 to 2023, so as to provide insights into precision control and elimination of schistosomiasis. The integrated measures for schistosomiasis control implemented by health, agriculture, water resources, and forestry departments of Wuhan City, and the epidemiological data of schistosomiasis in Wuhan City were collected from 2005 to 2023, and the prevalence of human schistosomiasis, prevalence of Schistosoma japonicum infections in humans and bovines, areas of S. japonicum-infected snail habitats, areas of snail habitats in inner embankments, and actual areas of snail habitats were retrieved. In addition, the trends in prevalence of schistosomiasis in humans and livestock and snail status were evaluated in Wuhan City from 2005 to 2023 using Mann-Kendall test and a Joinpoint regression model. Mann-Kendall test revealed a tendency towards a decline in the prevalence of human schistosomiasis (Z = -4.41, P < 0.01), prevalence of S. japonicum infections in humans (Z = -4.89, P < 0.01) and bovines (Z = -4.50, P < 0.01), areas of S. japonicum-infected snail habitats (Z = -3.91, P < 0.01), areas of snail habitats in inner embankments (Z = -2.28, P = 0.02), and actual areas of snail habitats (Z = -5.95, P < 0.01) in Wuhan City from 2005 to 2023. Joinpoint regression analysis showed an average annual reduction of 8.58% in the prevalence of human schistosomiasis in Wuhan City from 2005 to 2023 [average annual percent change (AAPC) = -8.58%, 95% confidence interval (CI): (-10.02%, -6.65%), P < 0.01], with two joinpoints in 2013 and 2016, respectively, and the tendency towards a decline showed statistical significance during the period from 2013 through 2016 [annual percent change (APC) = -34.41%, 95% CI: (-40.36%, -20.01%), P < 0.01]. The prevalence of S. japonicum human infections appeared an average annual reduction of 51.91% in Wuhan City from 2005 to 2023 [AAPC = -51.91%, 95% CI: (-58.12%, -44.25%), P < 0.01], with two joinpoints in 2014 and 2017, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.17%, 95% CI: (-99.17%, -90.87%), P < 0.01]. The prevalence of S. japonicum infections in bovines appeared an average annual reduction of 53.12% in Wuhan City from 2005 to 2023 [AAPC = -53.12%, 95% CI: (-59.65%, -42.44%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.63%, 95% CI: (-99.44%, -90.93%), P < 0.01]. The areas of S. japonicum-infected snail habitats appeared an average annual reduction of 47.09% in Wuhan City from 2005 to 2023 [AAPC = -47.09%, 95% CI: (-52.92%, -38.26%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2011 through 2014 [APC = -97.27%, 95% CI: (-98.65%, -88.06%), P < 0.01]. The areas of snail habitats in inner embankments appeared an average annual reduction of 4.45% in Wuhan City from 2005 to 2023 [AAPC = -4.45%, 95% CI: (-5.18%, -3.82%), P < 0.01], with three joinpoints in 2011, 2015 and 2018, respectively, and statistical significance was seen in the tendency towards a decline during the period from 2005 through 2011 [APC = -16.38%, 95% CI: (-20.15%, -14.25%), P < 0.01]. In addition, the actual areas of snail habitats appeared an average annual reduction of 2.65% in Wuhan City from 2005 to 2023 [AAPC = -2.65%, 95% CI: (-2.89%, -2.40%), P < 0.01], with a joinpoint in 2013, and the tendency towards a decline showed statistical significance during the period from 2013 through 2023 [APC = -4.06%, 95% CI: (-4.66%, -3.58%), P < 0.01]. The integrated schistosomiasis control programme achieved significant effectiveness in Wuhan City from 2005 to 2023, with a tendency towards a decline in morbidity due to schistosomiasis in humans and livestock and snail status. The integrated schistosomiasis control strategy with emphasis on management of the source of S. japonicum infections should continue to be implemented to consolidate the schistosomiasis control achievements and achieve the goal of schistosomiasis elimination in the city.

ObjectivesTo estimate the burden, trends, and inequalities of brain and central nervous system cancer (CNS cancer) among adults at global, regional and national level from 1992 to 2021.DesignPopulation-based study.PopulationAdults aged 20–64 years from 21 regions and 204 countries and territories (Global Burden of Disease and Risk Factors Study 2021) from 1992 to 2021.Main outcome measuresOur primary outcomes comprised age-standardised prevalence, incidence, mortality and disability-adjusted life-years (DALYs) for CNS cancers. The analytical framework incorporated temporal trend analysis through annual percentage change (APC) and average APC (AAPC) metrics, complemented by Bayesian age-period-cohort modelling to assess demographic influences. We employed predictive modelling with decomposition techniques to evaluate contributions from age structure shifts, population dynamics and risk factor modifications, while spatiotemporal Gaussian process regression enabled robust smoothing and trend estimation across continuous time-space dimensions. The study specifically applied frontier analysis methodologies to examine epidemiological patterns of prevalence, incidence, mortality and DALYs within the 20–64 years adult population.ResultsFrom 1992 to 2021, the global age-standardised prevalence (AAPC 1.04 (95% CI 0.91 to 1.18); p<0.001) and incidence (AAPC 0.23 (95% CI 0.14 to 0.31); p<0.001) of CNS cancer among adults aged 20–64 years increased, while age-standardised DALYs (AAPC −0.28 (95% CI −0.34 to −0.22); p<0.001) and mortality (AAPC −0.27 (95% CI −0.34 to −0.2); p<0.001) decreased. The most significant increase in prevalence (AAPC 1.67 (95% CI 1.47 to 1.87); p<0.001) and incidence (AAPC 0.7 (95% CI 0.61 to 0.79); p<0.001) was observed among those aged 20–24 years. The most significant decrease in DALYs (AAPC −0.45 (95% CI −0.55 to −0.35); p<0.001) and mortality (AAPC −0.46 (95% CI −0.56 to −0.36); p<0.001) was observed among those aged 40–44 years. The rate of increase in prevalence and incidence was lower in high sociodemographic index (SDI) (prevalence: AAPC 0.95 (95% CI 0.8 to 1.11); p<0.001), (incidence: AAPC 0.95 (95% CI 0.8 to 1.11); p<0.001) countries compared with low-SDI countries (prevalence: AAPC 0.5 (95% CI 0.43 to 0.57); p<0.001), (incidence: AAPC 0.12 (95% CI −0.07 to 0.31); p<0.001). DALYs and mortality began to decline in high-SDI countries (DALYs: AAPC −0.52 (95% CI −0.73 to −0.31); p<0.001), (mortality: AAPC −0.5 (95% CI −0.7 to −0.3); p<0.001), but these indicators continue to rise in low-SDI nations (DALYs: AAPC 0.45 (95% CI 0.39 to 0.51); p<0.001), (mortality: AAPC 0.38 (95% CI 0.31 to 0.46); p<0.001). Our predictive analysis found that from 2021 to 2050, the number of CNS cancer cases among people aged 20–64 years will be on the rise globally, which is expected to increase from 186 891 to 245 942, an increase of 31.6%.From 1992 to 2021, the global age-standardised prevalence and incidence of CNS cancer among adults aged 20–64 years increased, while age-standardised DALYs and mortality decreased. The most significant increase in prevalence and incidence was observed among those aged 20–24 years. The most significant decrease in DALYs and mortality was observed among those aged 40–44 years. The rate of increase in prevalence and incidence was lower in high SDI countries compared with low-SDI countries. DALYs and mortality began to decline in high-SDI countries, but these indicators continue to rise in low-SDI nations. Our predictive analysis found that from 2021 to 2050, the number of CNS cancer cases among people aged 20–64 years will be on the rise globally, which is expected to increase from 186 891 to 245 942, an increase of 31.6%.ConclusionsSignificant inequalities exist in age-standardised prevalence, incidence, DALYs and mortality of CNS cancer among countries with varying sociodemographic indices. These disparities highlight the urgent need for targeted clinical guidelines and equitable distribution of global health resources.

e18601 Background: Myeloproliferative neoplasms (MPNs) are a group of hematologic malignancies associated with substantial morbidity and mortality. Understanding long-term mortality trends is crucial for guiding healthcare strategies and assessing the impact of advancements in diagnosis and treatment. Methods: Mortality data, including age-standardized morality rate, for MPNs in the United States from 1990 to 2019 were obtained from the Global Burden of Disease database. Temporal trends were analyzed using Joinpoint regression analysis by calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: Total Mortality: An estimated total of 222,511 MPN-related deaths were reported from 1990 to 2019. Overall Trends: MPN-related mortality exhibited an overall increasing trend (AAPC: 0.102, 95% CI: 0.067 to 0.133; p &lt; 0.001). Mortality initially rose during 1990 to 2001 (APC: 0.67; p = 0.0004), followed by a decline from 2001 to 2004 (APC: -1.02; p = 0.037), and a subsequent increase from 2004 to 2011 (APC: 0.80; p = 0.037). A stabilization phase occurred from 2011 to 2015 (APC: -0.45; p &gt; 0.05), followed by a significant decline from 2015 to 2019 (APC: -1.44%; p &lt; 0.001). Gender-Specific Trends: Females: Mortality rates initially increased (APC: 0.85 from 1990 to 2001; p &lt; 0.001), followed by declines from 2001 to 2004 (APC: -1.17%; p &lt; 0.001) and fluctuations in subsequent years, with a final significant decline from 2016 to 2019 (APC: -1.91; p &lt; 0.001). The overall AAPC for females was 0.053%, which was not statistically significant (p = 0.323). Males: Mortality rates noticed an initial increase in the early 1990s (APC: 0.90 from 1990 to 1994; p &lt; 0.001), followed by a stabilization 1994 to 2001 (APC: 0.04; p &gt; 0.05), and then rose again from 2001 to 2005 (APC: 1.01; p &lt; 0.001) and 2005 to 2010 (APC: 1.34; p &lt; 0.001). A significant decline followed from 2014 to 2019 (APC: -1.46; p &lt; 0.001), with an overall AAPC of -0.07% (95% CI: -0.108 to -0.032; p &lt; 0.05). Conclusions: Over the last three decades, MPN-related mortality in the United States has demonstrated an initial increase followed by periods of stabilization and significant declines, particularly after 2014. Both males and females experienced mortality reductions in recent years, likely reflecting advancements in therapeutic strategies and improved disease management. Further investigations into gender-specific and global trends may provide additional insights into optimizing treatment and care for MPN patients.

e15707 Background: Patients with primary colorectal cancer (CRC) are at an increased risk of developing a second primary cancer (SPC) at any site. In the United States, incidence patterns of primary CRC are shifting, with a notable rise in early-onset CRC and a decline in late-onset CRC. However, trends in SPC incidence remain poorly understood. We analyzed SPC incidence, stratified by the anatomical location and stage at diagnosis of primary CRC. Methods: CRC cases diagnosed between 2000-2018 were identified using SEER.Stat 8.4.4. Patients developing a SPC with a latency period of &gt; 6 months, and at a different location from the primary were identified. Incidence rates were calculated as the number of SPC cases in a given year divided by person-years at risk. Patients were categorized into four groups based on the location of primary CRC 1: cecum, ascending colon and hepatic flexure, 2: transverse colon, 3: splenic flexure, descending colon and sigmoid colon, and 4: rectosigmoid junction, and rectum. Stages at diagnosis of primary CRC were classified as early (in situ, localized) or late (regional, distant). Annual percentage change (APC) and average APC (AAPC) were estimated using Jointpoint regression and weighted Bayesian Information Criteria (P &lt; 0.05). Results: 40,022 (10.21%) patients developed a SPC over the study period. The overall incidence of SPC decreased from 2000 to 2009 (APC: -0.61 (-2.70,-0.10)), while it increased from 2009 to 2018 (APC: 0.58 (0.05,2.69)). For early-stage primaries, overall SPC incidence increased from 2009 to 2018 (APC: 0.90 (0.42,2.31)), following a period of stability from 2000 to 2009 (APC: -0.41%, (-1.95,0.03)). Among anatomical groups, early-stage rectosigmoid junction and rectum showed a consistent increase in SPC incidence from 2000 to 2018 (AAPC: 0.66 (0.06,1.26)). For late-stage primaries, a decline in incidence of SPC was observed from 2000 to 2010 (APC: -0.68(-3.39,-0.09)), followed by a stable trend from 2010 to 2018 (APC: 0.66 (-0.16,3.39)). Splenic flexure, descending colon and sigmoid colon demonstrated a notable decline from 2000 to 2004 (APC: -5.4 (-13.4,-0.80)), with a continued decline overall from 2000 to 2018 (AAPC: -0.79(1.15,-0.43)). Late-stage rectosigmoid junction and rectum showed a decrease in SPC incidence from 2000 to 2018 (AAPC: -0.79(-1.15,-0.43)). Conclusions: The incidence of second primary cancers following primary colorectal cancer demonstrates conflicting trends across different stages of diagnosis and anatomical sites. These trends are influenced by improved screening practices, shifting demographics, lifestyle modifications, and potential genetic predispositions. These findings highlight the importance of targeted surveillance and prevention strategies for specific anatomical sites and stages of CRC.

BACKGROUNDThe United States (US)‐Mexico border is a socioeconomically underserved area. We sought to investigate whether stroke‐related mortality varies between the US border and nonborder counties.METHODS AND RESULTSWe used death certificates from the Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research database to examine stroke‐related mortality in border versus nonborder counties in California, Texas, New Mexico, and Arizona. We measured average annual percent changes (AAPCs) in age‐adjusted mortality rates (AAMRs) per 100 000 between 1999 and 2018. Overall, AAMRs were higher for nonborder counties, older adults, men, and non‐Hispanic Black adults than their counterparts. Between 1999 and 2018, AAMRs reduced from 55.8 per 100 000 to 34.4 per 100 000 in the border counties (AAPC, −2.70) and 64.5 per 100 000 to 37.6 per 100 000 in nonborder counties (AAPC, −2.92). The annual percent change in AAMR initially decreased, followed by stagnation in both border and nonborder counties since 2012. The AAPC in AAMR decreased in all 4 states; however, AAMR increased in California’s border counties since 2012 (annual percent change, 3.9). The annual percent change in AAMR decreased for older adults between 1999 and 2012 for the border (−5.10) and nonborder counties (−5.01), followed by a rise in border counties and stalling in nonborder counties. Although the AAPC in AAMR decreased for both sexes, the AAPC in AAMR differed significantly for non‐Hispanic White adults in border (−2.69) and nonborder counties (−2.86). The mortality decreased consistently for all other ethnicities/races in both border and nonborder counties.CONCLUSIONSStroke‐related mortality varied between the border and nonborder counties. Given the substantial public health implications, targeted interventions aimed at vulnerable populations are required to improve stroke‐related outcomes in the US‐Mexico border area.

Introduction: Chronic liver disease (CLD) and chronic kidney disease (CKD) often coexist due to overlapping risk factors such as diabetes, hypertension, and alcohol use, resulting in increased morbidity and mortality. The interplay between these conditions exacerbates systemic inflammation and accelerates organ dysfunction, especially in aging populations. Despite this, national mortality trends and disparities associated with CLD and CKD have not been well characterized. This study examines trends in CLD and CKD-related mortality among U.S. adults from 1999 to 2023, focusing on demographic and geographic disparities. Methods: Mortality data from 1999–2023 were extracted from the CDC WONDER database using International Classification of Diseases, Tenth Revision (ICD-10) codes for CLD and CKD. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression determined annual percent change (APC) and average annual percent change (AAPC), with significance at P < 0.05. Analyses were stratified by sex, age group, race/ethnicity, U.S. census region, urbanization, and state. Results: There were 67, 575 CLD and CKD-related deaths, with 68.5% occurring in inpatient settings. AAMRs increased by 333% from 0.51 in 1999 to 2.21 in 2023 (AAPC: 6.5%, 95% CI: 4.7–7.8, P < 0.000001). Men had 49% higher mortality than women (1.42 vs 0.95), but women experienced a slightly faster increase (AAPC: 6.8% vs 6.2%). Mortality rose sharply with age: 0.12 (25–44), 1.14 (45–64), and 3.33 (65+), though the steepest growth occurred in ages 25–44 (AAPC: 7.3%). Hispanics had the highest AAMR (1.93), while non-Hispanic (NH) Asians had the lowest (0.83). NH Whites experienced a 445% increase in AAMR (0.38 to 2.07; AAPC: 7.4%). The South (1.31) and West (1.30) had the highest AAMRs, with the West showing the steepest rise (AAPC: 7.2%). Rural areas had slightly lower mortality than urban (0.94 vs 1.02), but showed faster rise in mortality (AAPC: 6.7% vs 5.1%). States in the top 90th percentile included South Dakota, West Virginia, New Mexico, Texas, and Kentucky. Conclusion: From 1999 to 2023, mortality from comorbid CLD and CKD rose 333%, with the highest burden in older adults, men, Hispanics, and residents of the South and West. Notably, the steepest increase was seen in young adults (25–44 years) and rural populations, underscoring the need for early detection and targeted public health strategies.

Regional and sex differences in infective endocarditis mortality in Spain.

Traumatic brain injury (TBI) remains a critical global public health challenge, yet gaps in the evidence limit an understanding of its age-specific epidemiological profiles among adolescents and young adults. The aim of our analysis is to generate actionable evidence for tailoring prevention strategies and context-specific interventions aligned with the global epidemiological dataset in this population from 1990 to 2021. We used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, which reported on TBI-related years lived with disability (YLDs), prevalence, and annual average percentage change (AAPC) per 100,000 people. Joinpoint regression analysis was used to identify years with significant trend shifts. We also performed stratified analyses by age, sex, and sociodemographic index (SDI). Furthermore, we used the Bayesian age-period-cohort (BAPC) model to project the TBI burden through 2030. From 1990 to 2021, the prevalence and YLDs of TBI among adolescents and young adults decreased from 191.3 [177 to 208.9] and 28.8 [20.5–38.9] to 128.3 [117.8 to 139.1] (AAPC − 1.28 [95% UI − 1.31 to − 1.26], p < 0.001) to 19.4 [13.7–26] (AAPC − 1.28 [95% UI − 1.31 to − 1.25], p < 0.001). Specific changes in the prevalence of TBI occurred in 2001, 2005, 2010, and 2017. Regionally, eastern sub-Saharan Africa had the most substantial reduction in prevalence rate (AAPC = − 2.34[− 2.62 to − 2.05]) and YLD rates (AAPC = − 2.32[− 2.62 to − 2.02]). The prevalence rate substantially decreased in both sexes. The AAPC was − 1.3 (95% UI − 1.33 to − 1.27) for males, which was comparable to the AAPC of − 1.28 (95% UI − 1.34 to − 1.23) observed in females. The largest decrease in TBI prevalence from 1990 to 2021 was found among individuals aged 10–14 years (AAPC = − 1.45[− 1.49 to − 1.41]). In terms of the SDI quintile, the most pronounced reductions in TBI prevalence and YLD rates occurred in the high-SDI quintile countries. Among all causes of TBI, falls constitute the leading etiology, with its proportional contribution rising steadily from 31.9% in 1990 to 37.7% in 2021. However, the BAPC analysis predicted that the prevalence of TBI and YLDs attributable to TBI would increase from 2022 to 2030. This study further elaborates to report the global disease burden and temporal trends of TBI in adolescents and young adults. The global burden of TBI in adolescents and young adults aged 10–24 years decreased from 1990 to 2021. Although the disease burden has decreased in most regions, attention should still be given to specific regions to strengthen policy development and disease management.

Background: Increasing cancer incidence among young adults has been reported for several types of cancers, primarily in certain high-income countries. However, there is a lack of comprehensive examination of the global burden and trends in cancer incidence and mortality among young adults. Methods: We presented estimated numbers of cancer cases, cancer deaths, age-standardized incidence, and mortality rates per 100, 000 people among young adults (YAs, ages 25-49 years) for all cancers combined and 35 cancer sites in 185 countries and 20 UN regions using GLOBOCAN 2022. We further quantified trends in age-standardized incidence (ASIR; 52 countries) and age-standardized mortality (ASMR; 62 countries) for the top five incident cancers (female breast, cervix uteri, thyroid, colorectum, and trachea, bronchus and lung cancers) among YAs over the most recent decade by estimating average annual percent change (AAPC), using the Cancer Incidence in Five Continents (CI5; 2008-2017) and WHO mortality data (2011-2020; thyroid mortality data was not available), respectively. Results: In 2022, an estimated 2.9 million cancer cases and 962, 000 cancer-related deaths occurred in YAs worldwide, corresponding to 108.1 cases per 100, 000 people per year and 35.9 deaths per 100, 000 people per year. Globally, ASIR and ASMR were higher in women than men (143.7 vs. 73.5 for incidence; 40.0 vs. 32.0 for mortality). By UN region, ASIR per 100, 000 people was highest in Australia-New Zealand (185.7) and lowest in South Central Asia (72.5), while ASMR per 100, 000 was highest in Eastern Africa (55.9) and lowest in Northern Europe (21.9). For the most recent 10 years, increases in ASIRs were observed for thyroid cancer (AAPC, 2.5-19.6%) in 27 countries, for colorectal cancer (AAPC, 1.2-11.5%) in 20 countries, for female breast cancer (AAPC, 0.7-5.9%) in 17 countries, and for cervix uteri cancer (AAPC, 1.8-15.7%) in 4 countries. Increases in ASMR were observed for colorectum cancer (AAPC, 0.6-8.0%) in 13 countries, for female breast cancer (AAPC, 0.9-4.8%) in 11 countries, and for cervix uteri cancer (AAPC, 2.1-4.7%) in 6 countries. Incidence and mortality both increased in YAs for female breast cancer in Czechia, ovarian cancer in the Republic of Korea, cervix uterine cancer in the Netherlands, and colorectum cancer in Australia, Canada, Chile, and the USA. Trachea, bronchus and lung cancers ASIR and ASMR decreased in 24 (AAPC, -1.5 to -11.3%) and 47 (AAPC, -2.0 to -11.4%) countries among YAs, respectively. Conclusions and Relevance: The burden and trends in cancer among young adults vary significantly by sex and region. Rising incidence and mortality rates for multiple cancer types across the world underscore the need for renewed attention to cancer prevention efforts and improvements to cancer surveillance systems targeting this often overlooked age group. Citation Format: Kieran Patrick Kelly, Yejun Son, Nikita Sandeep Wagle, Dong Keon Yon, Ahmedin Jemal, Hyuna Sung. Global burden and trends in cancer incidence and mortality among young adults [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3591.