Colorectal cancer mortality dynamics: Uncovering critical disparities in U.S. population health (2018-2023)

Document Type

Conference Proceeding

Publication Date

5-28-2025

Publication Title

J Clin Oncol

Abstract

Background: Colorectal cancer(CRC) remains the third leading cause of cancer-related deaths in the United States, with a disproportionate burden on underserved populations. Despite established screening protocols and preventive measures, fewer than 35% of cases are detected early, significantly impacting survival rates. This study examines mortality patterns across demographic and geographic divides, revealing urgent public health priorities. Methods: This retrospective analysis was performed in adults aged 25 and older using the CDC WONDER database (2018-2023) using ICD-10 codes. We stratified mortality data by age, gender, race, geographic region and urbanization level to identify critical disparities and emerging trends. Crude mortality rates (CMRs) and Age-adjusted mortality rates (AAMRs) per 100,000 were calculated by age, gender, region and race, with 95% confidence intervals (CI) for precision. Temporal trends and annual percentage changes (APCs) were analyzed using Joinpoint regression. Results: From 2018 to 2023, among 313,744 deaths, mortality increased from 51,891 to 53,497, while theAAMR for CRC consistently declined from 12.92 to 12.44. The highestCMRwas in the 85+ group (156.11 per 100,000,95% CI: 153.05-159.17), followed by 75-84 (74.18,95%CI: 72.87-75.49), 65-74 (40.27, 95% CI: 39.58-40.96), and 55-64 (23.83, 95% CI: 23.37-24.30). The 45-54 group had a CMR of 11.74 (95% CI: 11.40-12.07), the 35-44 group 3.56 (95% CI: 3.38-3.74), the 25-34 group 0.77 (95% CI: 0.69-0.86), and the 15-24 group had the lowest at 0.09 (95% CI: 0.06-0.12). Males had a higher CMR of 17.23 per 100,000 (AAMR: 15.19, APC: -0.68, p = 0.21) than females, who had 14.42 per 100,000 (AAMR: 10.69, APC: -0.30, p = 0.56). The Midwest had the highest AAMR at 13.33 per 100,000 [APC: -0.78 (95% CI: -2.54 to 1.01, p = 0.31)], followed by the South at 13.54 [APC: 0.05 (95% CI: -0.80 to 0.92, p = 0.91)], the West at 11.90 [APC: 0.09 (95% CI: -0.79 to 0.95, p = 0.82)], and the Northeast at 11.54, with a significant decline in trends [APC: -1.90 (95% CI: -3.24 to -0.58, p < 0.01)]. Large central metro areas accounted for 25.3% of deaths (83,341), followed by large fringe metro areas (22.4%), medium metros (19.9%), micropolitan areas (10.0%), small metros (9.4%), and noncore areas (8.2%). Racial disparities showed White individuals with the highest CMR at 17.01 per 100,000 (AAMR: 12.69, APC: -0.78), while Black or African American individuals had a slightly lower CMR at 15.70 per 100,000 but the highest AAMR at 16.18 (APC: -1.63, p < 0.01), followed by American Indian or Alaska Native, Asian, Native Hawaiian, and other groups. Conclusions: These findings reveal critical gaps in CRC prevention and care, disproportionately affecting young adults, males, and minorities. Public health initiatives must expand screening, improve access to care, and address regional inequities to reduce mortality and promote health equity.

Volume

43

Issue

16

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