Trends in AML vs MDS mortality in the United States older adults from 1999-2023-a CDC wonder database analysis

Abstract Introduction: Acute Myeloid Leukemia (AML) and Myelodysplastic Syndromes (MDS) both primarily blood cancers of older age group have an incidence of 4.3 and 4.9 per 100,000 people. AML is the most common acute leukemia in adults, while MDS can lead to AML is 25% of cases with a poor prognosis. Methods: Age-adjusted mortality rates (AAMRs) per 100,000 in adults (65+) were obtained from the CDC WONDER using ICD-10 codes for Acute Myeloid Leukemia (CD92.0) and Myelodysplastic Syndrome (D46). Joinpoint regression estimated Annual Percent Change and Average APC, with significance set at p<0.05 Results: From 1999 to 2023 there were 159994 and 136171 deaths due to to AML and MDS respectively. The overall AAMR was slightly higher for AML than MDS (14.8 vs 12.7). The overall AAMR for AML rose from 12.5 to 14.9 with an Annual Percent Change of 5 by 2001, followed by a fall to 1 between 2011 and 2011, thereafter declining to -0.2 by 2023.AAMR per 100,000 for MDS related deaths rose from 11.7 in 1999 to 13.8 in 2009 with varied APCs declining from 1999 to 2004, before rising again in 2009. From 2009 to 2023 there were fluctuations in APC with -1.9 till 2014 and -2.2 in 2023 with an AAMR of 11.3. For both AML and MDS men had double the AAMR than women, with men having comparable AAMRs (20.2 vs 18.6). NH Whites had the highest AAMRs for AML and MDS related mortality with AAMRs of 15.5 and 13.5 respectively. Regionally, the Midwest had strikingly higher mortality observed in terms of both AML and MDS. Wisconsin had the highest AAMR for AMLwhile South Dakota ranked highest for MDS. Both AML and MDS mortality was comparable across all urbanization groups with Small Metro regions exhibiting higher AAMR in both groups (15.3 vs 13.9). Conclusion: AML related mortality is increasing while MDS related mortality has declined slightly with stable mortality rates. The highest AAMRs for both diseases were observed in NH Whites, men, People in Midwest. Urbanisation did not significantly altered mortality. These findings underscore the need for focused interventions aimed at early cancer screening initiatives to curb both the rising mortality of AML and fixed mortality in MDS, despite newer advancements especially in high risk populations.