Kaposi Sarcoma Incidence and Mortality Rates and Trends in the United States

Background Kaposi sarcoma (KS) is an angioproliferative tumor caused by human herpesvirus 8. Since antiretroviral therapy (ART) became widely available in the mid-1990s, KS incidence and mortality have fallen sharply—but persistent racial and sex disparities remain. Our aim was to characterize 1999–2020 trends in KS incidence and mortality in the United States overall, and by race and sex, and to quantify changes in disparities over time. Methods We extracted KS case and death counts from the CDC WONDER database (ICD-10 codes B21.0, C46). Age-adjusted incidence rates (AAIR) and mortality rates (AAMR) per 100,000 were calculated by year, race, and sex. Temporal trends were evaluated using the Mann–Kendall test (Kendall’s τ), and between-group differences by t-test (α = 0.05). Results From 1999–2020, 27,886 KS cases and 4,380 deaths occurred. Overall AAIR was 0.99 in men versus 0.10 in women, and AAMR 0.16 versus 0.01 (both p < 0.001). Black men experienced the highest AAIR (2.23) and AAMR (0.40), significantly exceeding White men (0.79 and 0.13; p < 0.001). Incidence declined by 46.7% in men (τ=–0.920) and 58.9% in women (τ=–0.848; both p < 0.001). Mortality decreased by 66.4% in men (τ=–0.581; p < 0.001) but rose non-significantly by 28.6% in women (τ=–0.303; p = 0.060). Conclusion Although KS incidence and mortality have declined markedly since 1999, Black men remain disproportionately affected. Focused public health efforts and enhanced access to HIV care are essential to close these gaps.