Objective:

We aim to identify the temporal trends in mortality of patients with primary malignant brain neoplasms (PMBNs) in the United States (US) stratified by age, sex, race, and region.

Background:

From 2014-2018, PMBNs constituted 29.1 percent of all newly diagnosed brain tumors, also being the number one cause of cancer-related deaths in males <40 years and females <20 years of age.

Design/Methods:

We analyzed death certificate data from the CDC-WONDER database for adults aged ≥25 years. We determined crude and age-adjusted mortality rates (AAMRs) per 100,000 population, and Joinpoint regression was used to calculate annual percent change (APC) and the average APC (AAPC) in the AAMRs.

Results:

From 1999 to 2020, a total of 314,347 fatalities were recorded in individuals with PMBNs. The AAMRs decreased markedly till 2006 (APC: -1.4), then increased till 2020 (APC: 0.4). The AAMR was higher for males (8.1) than females (5.3). A less prominent initial decline was observed till 2006 for males (APC: -1.2) than females (APC: -1.3), subsequently followed by a greater rise till 2020 for males (APC: 0.4) than females (APC: 0.3). Non-Hispanic (NH) Whites displayed the highest AAMR (7.5) while NH Asians or Pacific Islanders displayed the lowest (3.0). While the AAMRs initially decreased and later increased for the other races, the rates for NH Asians or Pacific Islanders remained stable throughout the study period. AAMRs also varied substantially by region (Midwest: 6.9; West: 6.6; South: 6.5; Northeast: 6.2). Non-metropolitan regions exhibited a higher AAMR (7.5) than metropolitan regions (6.7). Most deaths occurred at homes (48.9%).

Conclusions:

We observed an initial decline with a later incline in mortality rates related to PMBNs in adults in the US. Efforts to control the rising mortality rates of PMBNs should be targeted towards the high-risk groups such as males, NH Whites, and residents of the Midwest and non-metropolitan areas.