Trends in the Incidence of Rare Primary Cardiac Neoplasms: A Surveillance, Epidemiology, and End Results (SEER)-Based Analysis

Our plain-English summary of Trends in the Incidence of Rare Primary Cardiac Neoplasms: A Surveillance, Epidemiology, and End Results (SEER)-Based Analysis, by J.K. Alhousani, A. Abdelmageed, H. Khoursheed, et al (Curēus, 2025).

The study

• Authors: J.K. Alhousani, A. Abdelmageed, H. Khoursheed, S. Yaseen, M. Hamad, H. Askari, L. Abu Rabi, M. Taha, A. Barakat, A.J. Nashwan
• Journal: Curēus
• Published: 2025;17(9):e92613
• Read it: PubMed · Publisher · Free full text

Abstract

Background Primary malignant cardiac tumors (PMCTs) are considered extremely rare neoplasms, with limited population-level data on incidence patterns and future trends. This study aims to describe the epidemiology of PMCTs in the United States, focusing on three main histologic subtypes, such as sarcomas, lymphomas, and mesotheliomas, and to forecast incidence over the next decade. Methods We extracted cases of pathologically confirmed PMCTs diagnosed between 2000 and 2022 from the Surveillance, Epidemiology, and End Results (SEER) 17 Registries database. Incidence rates (IRs) were age-adjusted to the 2000 US Standard Population and stratified by histology, sex, age (<60 vs. ≥60 years), and race. Annual percent change and percentage change were calculated. Time series forecasting was performed using linear regression, ETS, ARIMA, and neural network autoregression models, with model selection based on root mean square error, mean absolute error, mean absolute percentage error, and residual diagnostics. Poisson and quasi-Poisson regression analyses evaluated demographic associations with incidence. Results From 2000 to 2022, PMCTs demonstrated distinct subtype-specific trends. Cardiac lymphoma incidence increased steadily, with forecasts predicting a rise from 0.062 per 100,000 in 2023 to 0.080 by 2032. Sarcoma incidence remained stable (~0.008-0.009 per 100,000) but was highly volatile year to year. Mesothelioma incidence was consistently low (<0.001 per 100,000) but projected to increase slightly over time. Age ≥60 years was strongly associated with higher sarcoma and mesothelioma incidence, whereas lymphoma showed no significant age-related difference. Sex and race disparities were evident: males had higher sarcoma and mesothelioma rates, while females had slightly higher lymphoma rates; Asian/Pacific Islander groups exhibited greater volatility in lymphoma incidence, and Black populations had the lowest incidence across subtypes. Conclusions PMCTs remain exceptionally rare, but incidence trends vary by histologic subtype. Cardiac lymphoma incidence is rising and expected to continue increasing, whereas sarcoma rates are stable, and mesotheliomas show a modest upward trajectory. These findings highlight the need for improved detection in high-risk groups, the integration of molecular data into registries, and the development of global cardiac tumor collaborations to refine epidemiologic understanding and improve patient care..

Copyright © 2025, Alhousani et al.

In plain English

This study used the US SEER 17 cancer registries (about 26.5% of the US population) to describe how often tumors the authors called primary malignant cardiac tumors (sarcoma, lymphoma and mesothelioma) were diagnosed from 2000 to 2022, and to forecast rates to 2032. Their site codes also included the mediastinum, and the number of patients is not reported. No asbestos or other exposure information was collected. Cardiac mesothelioma incidence was described as consistently below 0.001 per 100,000, and the overall forecast stayed around 0.001. Compared with younger people, people aged 60 or older had a mesothelioma rate ratio of 7.683 (95% CI 4.472 to 13.642). Compared with females, males had a ratio of 3.237 (95% CI 1.822 to 6.126). Year was not significant in these regression models. However, the linear model behind the overall mesothelioma forecast showed a significant time trend (p = 0.046). Lymphoma rates rose over time. Sarcoma rates were stable but varied yearly. The authors concluded that mesotheliomas, while rare overall, are increasing among older adults. In their discussion they suggested asbestos latency as a likely reason, while noting that SEER lacks exposure histories.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective population-based cancer registry analysis (SEER) with time-series forecasting and Poisson/quasi-Poisson regression
• Who was studied: Patients in the US SEER 17 registries (about 26.5% of the US population) diagnosed from January 1, 2000 to December 31, 2022 with pathologically confirmed primary malignant cardiac tumors (soft-tissue sarcomas, lymphomas, mesotheliomas). The site codes used (C38.0 to C38.3) cover the heart and also the anterior, posterior and unspecified mediastinum. The number of patients is not reported.
• Exposure: No exposure was measured. The study compared incidence by tumor type, sex, age group (under 60 vs 60 or older), race and year. Asbestos appears only in the authors' discussion, as a suggested explanation for higher mesothelioma rates in older adults.
• Main results:
  • Cardiac mesothelioma incidence was described as consistently below 0.001 per 100,000, but projected to increase slightly over time.
  • Overall cardiac mesothelioma forecast: a linear regression model was used. Its time predictor was statistically significant (p = 0.046), and the forecast showed a slow increase around a mean of 0.001.
  • Cardiac mesothelioma: people aged 60 or older had an incidence rate ratio of 7.683 (95% CI 4.472 to 13.642, p less than 0.001) compared with the younger group. Year was not significant in this model (IRR 1.026, p = 0.210), nor in the sex model (p = 0.119) or the race model (p = 0.066).
  • Cardiac mesothelioma: males had an incidence rate ratio of 3.237 (95% CI 1.822 to 6.126, p less than 0.001) compared with females.
  • Cardiac mesothelioma by race: no cases among American Indian/Alaska Native people. Compared with Asians, the rate ratios were 0.313 (95% CI 0.078 to 1.155, p = 0.085) for Black persons and 0.904 (95% CI 0.410 to 2.496, p = 0.823) for White persons; neither was statistically significant.
  • Cardiac mesothelioma forecast for people aged 60 or older: rising from roughly 0.004 per 100,000 in 2023 to 0.006 in 2032. The forecast for the under-60 group stayed at about 0.001.
  • Cardiac lymphoma incidence rose over time (IRR 1.054, 95% CI 1.048 to 1.061, p less than 0.001). Age 60 or older was not associated with a statistically significant difference (IRR 0.913, 95% CI 0.825 to 1.009, p = 0.076).
  • Overall cardiac lymphoma forecast: roughly 0.06 per 100,000 in 2023, rising to 0.07 per 100,000 in 2032.
  • Cardiac sarcoma: the older age group had an incidence rate ratio of 3.848 (95% CI 3.269 to 4.528, p less than 0.001). Year of diagnosis was not significant. Rates were highly volatile, and the forecast was stable at around 0.01 per 100,000.
• The authors' conclusion: The authors concluded that sarcomas remain stable but fluctuate year to year, lymphomas are steadily rising, and mesotheliomas, while rare overall, are increasing among older adults.
• Limitations the authors state:
  • Small case numbers limit statistical power and the precision of subgroup estimates.
  • SEER lacks exposure histories, immunosuppression status and molecular data, which limits the ability to assess causation.
  • Primary tumors may be misclassified as metastatic heart tumors, or the reverse.
  • Forecasts assume past trends continue and may not reflect sudden changes in exposure, diagnosis or treatment.
  • Small samples make race-specific findings fragile; a single extra case can shift results.

Topics

Medical terms in this study, explained in our Lexicon: Neoplasm, Epidemiology, SEER, Histological Subtype, Sarcoma, Mesothelioma, Incidence, Histology.

Related studies

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• Mesothelioma in the United States: a Surveillance, Epidemiology, and End Results (SEER)-Medicare investigation of treatment patterns and overall survival — J.L. Beebe-Dimmer, J.P. Fryzek, et al. (2016)
• Frequency of use and predictors of cancer-directed surgery in the management of malignant pleural mesothelioma in a community-based (Surveillance, Epidemiology, and End Results [SEER]) population — R.M. Flores, E. Riedel, et al. (2010)
• Addition of radiotherapy to surgery and chemotherapy improves survival in localized malignant pleural mesothelioma: A Surveillance, Epidemiology, and End Results (SEER) study — A.B. Thompson, T.J. Quinn, et al. (2020)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)
• Mesothelioma trends in the United States: an update based on Surveillance, Epidemiology, and End Results Program data for 1973 through 2003 — B. Price, A. Ware (2004)

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