Long-term trends and demographic disparities in renal cell carcinoma mortality in the United States, 1968–2023.

e16541 Background: Accounting for 2% of cancer diagnoses and deaths globally, renal cell carcinoma (RCC) is regarded as the 9th most commonly occurring malignancy in the United States (U.S.). Over the past few decades, the epidemiology of RCC has evolved in response to changes in population demographics, diagnostic practices, and exposure to established risk factors. We aimed to characterize long-term trends in RCC mortality and to examine temporal patterns across sex, race, and age groups. Methods: Data were obtained from the CDC WONDER Underlying Cause of Death database. RCC deaths were identified using ICD codes: ICD-8 code 189, ICD-9 code 189, and ICD-10 code C64. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 population were calculated for adults aged 25 years and older from 1968 to 2023. Annual Percent Changes (APCs) and Average Annual Percent Changes (AAPCs) were computed using Joinpoint regression. Results: Between 1968 and 2023, RCC accounted for 579,290 deaths. From 1968 to 1979, AAMR increased non-significantly (APC: 0.37%), followed by a significant rise from 1979 to 1991 (APC: 1.34%). A non-significant decline occurred between 1991 and 2002 (APC: −0.12%). Thereafter, AAMR declined significantly from 2002 to 2015 (APC: −0.86%), with a further significant decrease from 2015 to 2019 (APC: −2.41%). No significant change was observed from 2019 to 2023 (APC: −0.07%). Overall, a non- significant decline in AAMR was observed across the full study period (AAPC: −0.05%). Gender-based analysis revealed that males had a higher average AAMR (8.5) compared with females (3.8). From 1968 to 2023, AAMR declined significantly among females (AAPC: −0.22%), whereas a non-significant increase was observed among males (AAPC: 0.04%). Compared with the Black population (5.3), the White population had a higher average AAMR (6.0). Over the study period, AAMR increased significantly among the Black population (AAPC: 0.22%), whereas a non-significant decline was observed among the White population (AAPC: −0.03%). Age-group stratification using age-specific CMR revealed that CMR declined significantly among individuals aged 25–34 years (AAPC: −0.85%), 35–44 years (AAPC: −1.22%), 45–54 years (AAPC: −0.97%), 55–64 years (AAPC: −0.55%), and 65–74 years (AAPC: −0.22%). In contrast, CMR increased significantly among those aged 75–84 years (AAPC: 0.31%) and 85 years and older (AAPC: 1.43%). Conclusions: RCC mortality demonstrated substantial temporal heterogeneity across sex, race, and age strata. Declining trends were observed among females and younger individuals, whereas the Black population and adults aged ≥75 years experienced increasing mortality. Continued monitoring of RCC mortality is warranted to guide targeted prevention, improve treatment equity, and reduce persistent disparities.