Trends in Colorectal Cancer Mortality in the United States, 1999 - 2020

Abstract

Background: The United States faces a significant public health issue with colorectal cancer (CRC), which remains the third leading cause of cancer-related fatalities despite early diagnosis and treatment progress.

Methods: This investigation utilized death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to investigate trends in CRC mortality and location of death from 1999 to 2020. Additionally, the study utilized the annual percent change (APC) to estimate the average annual rate of change over the specific time period for the given health outcome. Incorporating the location of death in this study served the purpose of identifying patterns related to CRC and offering valuable insights into the specific locations where deaths occurred.

Results: Between 1999 and 2020, there were 1,166,158 CRC-related deaths. The age-adjusted mortality rates (AAMRs) for CRC consistently declined from 20.7 in 1999 to 12.5 in 2020. Men had higher AAMR (18.8) than women (13.4) throughout the study. Black or African American patients had the highest AAMR (21.1), followed by White (15.4), Hispanic/Latino (11.8), American Indian or Alaska native (11.4), and Asian or Pacific Islanders (10.2). The location of death varied, with 41.99% at home, 28.16% in medical facilities, 16.6% in nursing homes/long-term care facilities, 7.43% in hospices, and 5.80% at other/unknown places.

Conclusion: There has been an overall improvement in AAMR among most ethnic groups, but an increase in AAMR has been observed among white individuals below the age of 55. Notably, over one-quarter of CRC-related deaths occur in medical facilities.

Keywords: Black/African American; Colorectal cancer; Hispanic/Latino; Mortality; Population; White/Caucasian.

Figure 1

Combined AAMR for both males and females. AAMR is represented on y-axis, while x-axis indicates the years spanning from 1999 to 2020. This graph demonstrates a consistent decrease in the AAMR for CRC from 20.7 per 100,000 population in 1999 to 12.5 per 100,000 population in 2020, indicating a significant improvement in the AAMR for CRC over the specified time period. AAMR: age-adjusted mortality rate; CRC: colorectal cancer.

Figure 2

AAMR for CRC is stratified for male (a) and female (b). Y-axis on both graphs represents AAMR, while x-axis represents the years spanning from 1999 to 2020. Both graphs demonstrate a significant improvement in the AAMR. For men, the AAMR decreased from 25.1 to 15.1, and for women, it decreased from 17.6 to 10.4. AAMR: age-adjusted mortality rate; CRC: colorectal cancer.

Figure 3

AAMR associated with CRC is stratified by race/ethnicity, with x-axis representing the year and race and y-axis indicating the AAMR. Green line: African American patients (AAMR decreased from 28.2 in 1999 to 16.1 in 2020). Orange line: White patients (AAMR decreased from 20.3 in 1999 to 12.4 in 2020). Red line: American Indian or Alaska native patients (AAMR decreased from 13.4 in 1999 to 9.7 in 2020). Blue line: Asian and Pacific Islander patients (AAMR decreased from 12 in 1999 to 8.7 in 2020). AAMR: age-adjusted mortality rate; CRC: colorectal cancer.

Figure 4

AAMR in white patients below the age of < 55 years, indicating an increase in the mortality rate from 2.4 to 2.8. AAMR: age-adjusted mortality rate.