EPID-15. Geographic and age-based disparities in brain tumor mortality in the United States, 1999–2020

Abstract Understanding how brain tumor mortality varies by geography and age may reveal critical disparities in healthcare access, environmental exposures, and regional care patterns. We used data from the CDC WONDER database to examine mortality trends from 1999 to 2020 for malignant brain tumors, defined using ICD-10 code C71. Trends were analyzed across U.S. Census regions (Northeast, Midwest, South, West) and age groups (0–19, 20–64, 65+). Linear regression models assessed temporal trends and region-year interactions. Age-stratified models were used to examine differential mortality burden. Older adults (65+) experienced the highest increase in brain tumor mortality (β = 188.84, p < 0.0001), followed by adults aged 20–64 (β = 14.22, p = 0.0014). Pediatric mortality showed a modest, non-significant decline (β = –1.79, p = 0.072). A significant overall time trend was observed (β = 43.23, p < 0.0001). The South showed the greatest relative increase in mortality over time (β = 65.69, p < 0.0001), followed by the West (β = 24.63, p = 0.0003), while the Northeast did not differ significantly from the Midwest reference group (β = –2.32, p = 0.72). Heatmap visualizations indicated a persistent mortality burden in the South and Midwest across the 24-year period. These findings highlight that age is the strongest driver of brain tumor mortality, with older adults disproportionately affected. Regional trends were statistically significant, with evidence of growing geographic disparities in outcomes. Limiting the analysis to ICD-10 code C71 ensures diagnostic specificity but may underestimate the full mortality burden from central nervous system neoplasms. Continued surveillance and regionally targeted interventions may help mitigate age- and region-associated disparities in brain tumor outcomes.