SUN-826 Rural vs. Urban: Emerging Trends in Paraganglioma Incidence Across U.S. Counties

Abstract Disclosure: S. Keritum: None. J. kenmoe: None. A. Shrestha: None. H. Ghumman: None. Rural vs. Urban: Emerging Trends in Paraganglioma Incidence Across U.S. Counties Shereen Keritum1, Jerry Kenmoe1, Anjela Shrestha1, Harneet Ghumman11. Michigan State University/McLaren Regional Medical Center Background: Paragangliomas are rare neuroendocrine tumors, and little is known about how their incidencevaries by county-level residence. This study investigates the incidence trends of paragangliomasacross metropolitan and non-metropolitan counties in the United States using SEER data from2000 to 2021. Methods: A retrospective cohort analysis was conducted using SEER*Stat software. Incidence rates per100,000 person-years were calculated for residents of metropolitan and non-metropolitancounties. Temporal trends were analyzed using Joinpoint regression to detect significant changesover the study period. Results: From 2000 to 2021, the overall incidence of paragangliomas was stable at 0.05 per 100,000person-years. Metropolitan counties consistently exhibited slightly higher, but similar trend inincidence rates from 2007 onward, compared to non-metropolitan counties. However, both areasdemonstrated a sharp and statistically significant rise in incidence starting in 2019. Conclusions: The incidence of paragangliomas has remained stable over the past two decades, with a markedrise observed across both metropolitan and non-metropolitan counties starting in 2019. Thedainty higher rates in metropolitan areas prior to 2019 may reflect differences in healthcareaccess, diagnostic advancements, or environmental exposures. Further investigation is needed tounderstand the drivers of this increase. Figure 1: Incidence of Paragangliomas by County 2000-2021 Presentation: Sunday, July 13, 2025