Title : Cerebral palsy-related mortality among older adults (?65 years) with malignancy in the U.S., 1999–2020
Abstract:
Introduction: Cerebral palsy (CP) is a lifelong motor disorder, while malignancy remains a major global health burden. Though rarely studied together, emerging evidence shows that individuals with CP face elevated cancer-related mortality, particularly from esophageal, colon, liver, breast, and bladder cancers.
Objective: To examine malignancy-related mortality trends in individuals with cerebral palsy aged 25–85 in the U.S. from 1999 to 2020.
Methods: Death certificates from the CDC-WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database were examined among older adults ≥ 65 years.Age adjusted mortality rates (AAMR) per 1,000,000 and annual percent changes (APC) ,along with 95%CI, were calculated through joinpoint regression analysis.
Results: Between 1999 and 2020 , a total of 17,673 deaths occurred due to malignant neoplasms and CP and other paralytic syndromes. The overall AAMR dereased from 31.15 (95%CI: 29.3 to 33.01) in 1999 to 20.91(95%CI : 19.68 to 22.14).Males consistently had higher AAMR than females from 1999 ( Males: 44.3 ;Females: 22.95 ) to 2020( Males: 27.99 ; Females 15.53). Nonhispanics(NH) Black or African American had the highest overall AAMR (26.51) followed by NH white ( 19.04), NH American Indian or Alaska Native ( 17.88),NH Asian or Pacific Islander( 15.03), and Hispanics or Latino(13.62). AAMR also varied substantially by region with the Midwest had the highest AAMR ( 23.74),followed by the West (20.59), the South( 17.14)and the Northeast(16.44) and nonmetropolitan areas had higher AAMR (23.64) than metropolitan areas (18.29). Among the states North Dakota had the highest AAMR ( 3.47),followed by the South Dakota ( 3.3), Minnesota(3.29),and Missouri(3.08) , while Arizona had the lowest AAMR(0.86) among the states.Most deaths ( 36.08%) occurred in the Nursing homes/Long term care units. Other common locations included Medical facilities (29.29), Decedent’s home(26.23%), and Hospice facility (4.63%).
Conclusion: We found an overall decreasing trend from 1999 to 2012 followed by a sharp significant increase till 2020.The highest AAMR were observed among male gender,NH Black or African American ethnicity.Among patients living in the Midwest region and nonmetropolitan areas. Interventions are essential to reduce CP and other paralytic syndrome related maliganancy , especially among vulnerable population.
