Shifting trends and disparities in colorectal cancer and heart failure-related mortality in the United States: A two-decade retrospective analysis

Abstract

Background: Colorectal cancer (CRC) and heart failure (HF) are significant contributors to morbidity and mortality, particularly when they co-occur. This study aims to analyze the trends in mortality related to both CRC and HF from 1999 to 2020, identifying demographic and geographical variations that could inform targeted interventions.

Methods: We examined death certificate data from the CDC WONDER database to assess trends in CRC and HF-related mortality over a 22-year period. We calculated annual percentage changes (APCs) in age-adjusted mortality rates (AAMRs), stratified by race, gender geographical region and age group.

Results: Between 1999 and 2020, there were 60,918 deaths attributed to CRC and HF. The AAMRs declined from 9.6 per 100,000 in 1999 to 0.92 in 2015, followed by an increase to 1.12 in 2020. Men consistently exhibited higher AAMRs (1.6) compared to women (1.07). By race, non-Hispanic Black individuals had the highest AAMRs (1.36), closely followed by non-Hispanic Whites (1.35), with Hispanic (0.69) and non-Hispanic Asian or Pacific Islander individuals (0.54) having lower rates. Geographical analysis revealed that the Midwest had the highest AAMR (1.53), with the Northeast (1.27), West (1.24), and South (1.16) following. Metropolitan areas recorded higher AAMRs (1.69) compared to non-metropolitan areas (1.19).

Conclusion: The study indicates a worrying rise in CRC and HF-related mortality from 2015 to 2020, following earlier declines. This upward trend across diverse demographics and regions highlights an urgent need for targeted public health strategies and healthcare policies to address these increases.

Keywords: CDC WONDER; Colorectal cancer; Heart failure; Mortality; Trends; United States.