Higher Mortality Rates from Ocular Cancer Seen Among Men, Older Adults

US mortality data from ocular and adnexal cancers increased modestly from 1999 to 2023 with persistent sex, regional and urban-rural disparities. These findings highlight enduring structural inequalities and underscore the need for targeted public health interventions. Photo: Carol Shields, MD. Click image to enlarge. The epidemiology of ocular cancers presents distinctive measurement challenges, and mortality patterns for malignant neoplasms of the eye and adnexa remain under-described at the national scale. Researchers of a recent study examined these patterns from 1999 to 2023 and found key disparities were observed across demographic and geographic strata, with higher mortality rates among male patients, older adults and residents of the Western and Midwestern regions. The findings were reported in Eye.Using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database as their primary source, the researchers identified US individuals aged 25 and older with ICD-10 diagnoses of ocular cancers. Age-adjusted mortality rates and trends were assessed; analyses were stratified by sex, age, census region, urbanization, place of death and education.The national age-adjusted mortality rate exhibited a significant increase from 0.12 per 100,000 in 1999 to 0.16 per 100,000 in 2023. Population aging likely amplifies deaths in an older-skewed disease, consistent with steeper increases among the oldest to old, the authors noted in their paper. “Incremental improvements in certification and coding may modestly increase attribution of ocular cancer as the underlying cause of death, though such effects should be gradual and small. Incidence and survival may also be moving in offsetting directions (e.g., stage migration or a shift toward more aggressive phenotypes), yielding flat or rising mortality despite better treatments.”Male mortality consistently exceeded female mortality, though the relative growth was steeper in women. The researchers noted that this distinction aligns with established risk correlates—lighter pigmentation in some ancestry groups, higher occupational ultraviolet (UV) exposure and historically greater smoking prevalence.Mortality risk escalated with age, particularly among those aged 85 and older. The post-2017 acceleration in adults aged 45 to 54 years, although occurring at low absolute rates, warrants surveillance as a potential early-onset signal, the authors wrote in their paper. The West region of the US recorded the highest mortality rates, while the Northeast had the lowest. Notably, the South experienced a sharp, significant increase in mortality after 2016. “These gradients plausibly reflect interacting differences in ancestry-linked pigmentation (with implications for uveal melanoma risk), ambient UV irradiance, spatial access to ocular oncology and proton facilities, referral efficiency and end-of-life practice patterns,” the authors explained in their paper. The increase in the South may reflect difficulty accessing subspecialty services, population shifts or state-specific factors, the researchers pointed out in their paper.From 1999 to 2020, deaths occurring at home and in-hospice care significantly increased, while hospital-based deaths remained stable. This mirrors broader US end-of-life trends and likely stems from expanded hospice coverage, earlier palliative integration and shifting preferences. “For ocular cancers—where vision loss, disfigurement and metastatic symptoms jointly shape quality of life—timely palliative referral and caregiver support are especially important, particularly far from tertiary centers,” the authors wrote in their paper.In conclusion, researchers emphasize the need for targeted public health interventions, including enhanced UV protection, improved referral networks to specialized ocular oncology centers and prioritized palliative support for patients with advanced disease.Click here for the journal source. Li D, Bi Y, Qin H, et al. Demographic trends and geographic disparities in malignant neoplasm of eye and adnexa-related mortality in the United States, 1999-2023. Eye. March 20, 2026. [Epub ahead of print.]  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.