National trends in bone-metastatic prostate cancer mortality in the United States, 1999–2024: a multiple-cause-of-death analysis with projections to 2040

作者：Kanza Atif, Eshal Atif, Vishan Das, Alaa Eldeeb, Kaneez Fatima, Sadia Qazi, Aziz Abdullah · 发表于：Frontiers in Oncology · 年份：2026 · DOI：10.3389/fonc.2026.1882666 · 研究领域：Prostate Cancer Diagnosis and Treatment、Bone health and treatments、Prostate Cancer Treatment and Research

Background: Conventional underlying-cause surveillance shows a declining prostate cancer mortality trend in the United States. MCOD analysis, which also includes deaths where bone metastasis was co-documented as a contributing cause, may identify a different trajectory than single-cause coding. Objective: To characterize 25-year trends in prostate cancer mortality with co-documented bone metastasis, quantify divergence from underlying-cause surveillance, and project age-adjusted mortality rates (AAMRs) to 2040 across demographic and geographic subgroups. Methods: We queried CDC WONDER (1999-2024) for deaths with prostate cancer (ICD-10: C61) as the underlying cause and bone metastasis (C79.5) as a contributing cause. Joinpoint regression characterized temporal trends, and ARIMA and exponential smoothing models with RMSE/MAPE-based selection generated stratum-specific projections. Analyses were stratified by age, race/ethnicity, US Census region, and urbanization. Results: In total, 73,429 deaths met the dual-code definition. The overall AAMR rose 93%, from 1.10 to 2.12 per 100,000 [average annual percent change (AAPC): +2.61%; 95% CI: 1.66-3.56; p < 0.000001]; however, this net increase followed an initial decline from 1999 to 2006 [annual percent change (APC): -5.57%] and reflected an acceleration to +12.91% annually during 2013-2018. Conventional underlying-cause surveillance showed an AAPC of -1.55%. Non-Hispanic Black or African American men had a mean AAMR 64% higher tha...