Malnutrition and deaths associated with cancer in the United States.

Abstract

e22579 Background: Patients with cancer have a heightened risk of malnutrition. The prevalence of malnutrition among cancer patients ranges from approximately 40% to 80%. Consequently, our analysis using CDC data aims to investigate mortality trends in patients facing both conditions from 1999 to 2023 in the United States. Methods: We accessed the CDC WONDER Multiple Cause of Death database spanning from 1999 to 2023, identifying all individuals who died of malignant neoplasm (ICD-10: C00-D48) listed as the primary cause of death, while malnutrition (ICD-10: E40-E46) was documented as a contributing factor. We assessed disparities across different racial/ethnic groups, census regions, and urban versus rural locations. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 individuals. The annual percent change (APC) and average APC were determined using the Joinpoint regression software (Version 5.4). Results: There were a total of 163,907 deaths related to malnutrition among cancer patients. Overall, the AAMR rose from 2.81 (95% CI: 2.73 to 2.89) in 1999 to 6.03 (95% CI: 5.94 to 6.12) in 2023 (AAPC: 3.31; 95% CI: 2.64 to 3.99; p< 0.000001), with the most significant increase observed between 2013 and 2023 (APC: 11.79; 95% CI: 11.18 to 12.41; p<0.000001). The rise in mortality was slightly more pronounced in women than in men (AAPC: 3.37 vs 2.99). The highest incidence rates were noted among the non-Hispanic (NH) Black or African American population, followed by NH White and Hispanic or Latino. Geographic disparities were apparent, with the South experiencing the greatest impact, while the Northeast was the least affected. Rural regions consistently showed higher AAMR compared to urban areas, though urban locations experienced a steeper increase between the two (AAPC: 2.34 vs 1.49). Conclusions: Black men encounter significantly elevated rates of malnutrition-related cancer incidence and mortality when compared to other racial groups. This upward trend highlights the pressing need for focused interventions and resource distribution to tackle these disparities and achieve favorable outcomes. Deaths and AAMRs per 100,000 for trends related to malnutrition in cancer patients from 1999 to 2023. Variable Deaths AAMR (95%CI)1999 AAMR (95% CI)2023 Overall 163,907 2.81(2.71 to 2.89) 6.03(5.94 to 6.12) Male 87,961 3.64(3.49 to 3.78) 7.28(7.13 to 7.43) Female 75,946 87,961 2.31(2.22 to 2.40) 4.99(4.87 to 5.10) NH Blacks 23,335 5.30(4.93 to 5.68) 7.50(7.17 to 7.83) NH White 123,137 2.59(2.51 to 2.68) 6.19(6.08 to 6.30) Hispanic or Latino 11,282 2.39(2.05 to 2.73) 2.86(1.67 to 4.06) South 70,248 3.07(2.94 to 3.21) 6.22(6.07 to 6.37) West 41,542 2.70(2.53 to 2.88) 6.97(6.76 to 7.10) Midwest 38,769 3.25(3.08 to 3.42) 6.8096.58 to 7.18) Northeast 19,138 2.06(1.91 to 2.20) 3.51(3.35 to 3.68) Urban 94,409 2.65(2.56 to 2.73) 4.13(4.05 to 4.22) Rural 25,566 3.70(3.49 to 3.91) 4.87 (4.66 to 5.08)