Study Reveals Disparities in MDS Mortality Among Older Adults in the United States

A retrospective study presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology in Houston, Texas, analyzed mortality due to myelodysplastic syndromes (MDS) among older adults (≥65 years) in the United States from 1999 to 2020, revealing significant disparities.

Using data from the Centers for Disease Control and Prevention’s WONDER database, researchers examined age-adjusted mortality rates (AAMRs) across various demographics, including age, sex, race, geographic region, rural/urban classification, and place of death. They used joinpoint regression to assess trends and calculate the annual percentage change (APC).

From 1999 to 2020, a total of 203,777 MDS-related deaths were recorded among older adults, with an AAMR of 22.2 per 100,000 (95% CI, 22.1–22.3). AAMR increased steadily from 1999 to 2011 (APC, 1.76; 95% CI, 1.38–2.21), followed by a significant decline from 2011 to 2020 (APC, –2.39; 95% CI, –3.06 to –1.84). Despite overall improvements in survival rates, disparities persisted across different demographic groups.

MDS Survival Disparity Among Older Patients

Male patients with MDS had a notably higher AAMR (33 per 100,000) compared to females (15.4 per 100,000). Non-Hispanic individuals experienced higher mortality rates (22.9) than their Hispanic counterparts (12.9), whereas White patients had higher AAMR (24.3) compared with Black patients (13.2). Geographic differences were also evident, with the Midwest showing the highest AAMR (25.2) and the South having the lowest (20.8). At the state level, South Dakota (30.7) and Minnesota (28.9) recorded the highest rates, whereas the District of Columbia (15) and Mississippi (13.6) had the lowest.

The analysis revealed that rural areas faced a slightly higher AAMR (22.6) compared with urban regions (22.2). Most MDS-related deaths occurred in inpatient settings (35.7%) and homes (31.5%). People aged 75–84 years accounted for the largest proportion of MDS-related deaths (41%), highlighting this age bracket as particularly vulnerable.

The study concluded that although MDS-related mortality has declined since 2011, significant disparities remain. Higher mortality rates among males, residents of the Midwest, White individuals, and those living in rural areas suggest that targeted interventions are necessary. According to the study, expanding access to healthcare in underserved regions and implementing tailored prevention programs could help address these disparities and reduce MDS-related deaths in certain populations.

Reference

Shah MDA, Saria HM, Hussain A, et al. Disparities in myelodysplastic syndromes mortality among older adults in the United States: a CDC WONDER database analysis. Abstract #MDS-304. Presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology. September 4-7, 2024; Houston, Texas.