Evolving Trends in Laryngeal Cancer Mortality in the United States, 1999-2024: A Population-Based Analysis With Subgroup Stratified Trends through 2020.

Abstract

Background: Laryngeal cancer (LC) represents one-third of all head and neck cancers, with global deaths rising by 36.7% between 1990 and 2021. Although mortality has declined over the past two decades, recent data indicate a potential slowdown in this progress. This study evaluated temporal trends in laryngeal cancer mortality in the United States.

Methods: LC mortality data from 1999 to 2024 were obtained from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated using Joinpoint regression analysis to assess temporal trends.

Results: Between 1999 and 2024, 129,275 LC-related deaths were recorded in the United States. The overall age-adjusted mortality rate (AAMR) declined from 3.76 to 2.25 per 100,000, with a significant decrease from 1999-2016 (APC: -2.75%; 95% CI, -2.92 to -2.58; p < 0.001), followed by a non-significant change from 2016-2024 (APC: -0.38%; 95% CI, -0.87 to 0.11; p = 0.12). Mortality was consistently higher in males than females, declining from 7.00 to 3.94 and 1.40 to 0.85 per 100,000, respectively. In 1999-2020 analyses, NH-Black individuals had the highest mortality, followed by NH-American Indian or Alaska Native and NH-White populations, with significant declines across all racial/ethnic groups (p < 0.001). Highest state-level AAMRs were observed in Kentucky, West Virginia, Louisiana, Tennessee, Ohio, and the District of Columbia (reported separately as a federal district). Mortality declined across all age groups and was consistently higher in non-metropolitan than metropolitan areas (all trend tests p < 0.05).

Conclusion: LC mortality in the United States has declined since 1999, but the rate of decline has slowed in recent years. Marked disparities persist by sex, race/ethnicity, age, and geographic region, with higher mortality in males, NH-Black individuals, older adults, and non-metropolitan areas. These findings underscore the need for continued surveillance and targeted interventions.