The objective of this study is to investigate the mortality trends and disparities related to comorbid malignant neoplasms and cerebrovascular disease.

The risk of cerebrovascular disease among patients with malignant neoplasms is increased due to tumor-related factors, hypercoagulability, and treatment toxicity. Given the limited existing data, this study aims to characterize contemporary trends in cerebrovascular disease–related mortality among United States (US) adults (≥25 years) with coexisting malignant neoplasm.

The death data was analyzed using the CDC WONDER mortality database, The age-adjusted mortality rates (AAMR) per 100,000 population were extracted. Cerebrovascular disease was identified using ICD-10 codes I60-I69, and malignant neoplasms were identified using ICD-10 codes C00-C97. Those deaths were included in the analysis where both conditions were either the underlying or contributing cause. Trends were analyzed by year, sex, census region, and race/ethnicity. Joinpoint regression was used to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Weighted average APCs were calculated and reported as AAPCs with 95% CIs to summarize mortality trends over the study period.

From 1999 to 2024, a total of 525,334 deaths were attributed to coexisting cerebrovascular disease and malignant neoplasms, with an overall average AAMR of 9.06 per 100,000. The AAMR declined from 11.80 in 1999 to 10.07 in 2024 (AAPC: –0.74; p < 0.001). Men had a higher average AAMR than women (11.69 vs 7.31), though both showed significant decline (men: AAPC –1.10; p < 0.001; women: AAPC –0.55; p < 0.001). Among races, non-Hispanic Black/African Americans (12.61) had the highest average AAMR. By region, the Midwest region had the highest average AAMR (9.69) compared to others.

The mortality related to cerebrovascular disease and malignant neoplasms has significantly declined since 1999, though significant disparities persist across sex, race, and region, underscoring the need for targeted prevention and intervention strategies.