Colorectal cancer with hypertension among middle aged and older adults in United States, 1999-2023.

Abstract

e15683 Background: Colorectal cancer (CRC) is a major cause of cancer-related morbidity and mortality globally. Hypertension is a common chronic condition that may contribute to cancer development through mechanisms such as chronic inflammation, metabolic changes, and vascular dysfunction. Investigating this association is important for identifying high-risk groups and improving prevention and management strategies. Methods: We analyzed CDC WONDER data (1999–2023) for adults aged ≥45 years with colorectal cancer (ICD-10: C18–C20) and hypertension (ICD-10: I10–I15). Age-adjusted mortality rates per 100,000 population were calculated and stratified by sex, race/ethnicity, and geographic region. Temporal trends were assessed using Joinpoint regression to estimate the average annual percent change. Results: From 1999 to 2023, a total of 141,347 deaths were reported among hypertensive patients with colorectal cancer, with most occurring at the decedent's home. The overall AAMR increased from 2.8 in 1999 to 5.65 in 2023 (AAPC: 2.78; 95% CI: 1.45–4.14), with the most significant rise observed between 1999 and 2001 (APC: 22.96; 95% CI: 7.29–40.92), followed by a notable decline through 2017 (APC: -2.04; 95% CI: -3.03 to -1.05), before rising again significantly by 2023 (APC: 6.15; 95% CI: 4.43–7.91). Adults aged 65–85 years and older experienced the greatest annual increase (2.04%). Men consistently showed higher annual increases in mortality compared with women (3.15 vs. 2.00). The highest AAMRs were observed among non-Hispanic Blacks, while the lowest were noted among non-Hispanic Asians. Geographically, the Midwest experienced the greatest increase, while the Northeast showed the smallest rise. Metropolitan areas showed a steeper increase than non-metropolitan areas (AAPC: 2.26 vs. 1.74). Mississippi and Oklahoma ranked highest, falling within the top 90th percentile. Conclusions: Colorectal cancer in patients with hypertension is highest among men, older adults, NH Black individuals, and people living in the Midwest, showing differences in risk and health outcomes. These results emphasize the need for targeted prevention, early detection, and better management to improve care and reduce disparities in these high-risk groups. Deaths and Age-adjusted Mortality Rates (AAMRs) per 100,000 for trends related toColorectal cancer in Hypertensive patients from 1999 to 2023. Variable Deaths AAMR (95%CI) 1999 AAMR (95% CI)2023 Overall 141,347 2.8(2.69 to 2.9) 5.65(5.53 to 5.77) Male 68,760 2.94(2.76 to 3.12) 7.04 (6.83 to 7.25) Female 72,587 2.7(2.56 to 2.83) 4.52(4.38 to 4.67) NH Blacks 21,185 5.94 (5.39 to 6.48) 8.6(8.11 to 9.08) NH Asians 3,832 2.01 (1.39 to 2.83) 3.41(3 to 3.82) Midwest 33,515 3.3 (3.06 to 3.53) 5.02 (4.77 to 5.28) Northeast 25,498 2.97 (2.73 to 3.21) 4.25 (4 to 4.49) Metro 91,987 2.79 (2.67 to 2.91) (2020) 4.76 (4.63 to 4.81) Non- metro 24,860 2.86 ( 2.62 to 3.11) 6.64 (6.31 to 6.96)