National trends and disparities in cancer-related mortality among adults with diabetes in the U.S., 1999–2023.

Abstract

e21003 Background: The prevalence of diabetes in the U.S. has nearly doubled, contributing to increased cancer risk due to inflammation and obesity, etc. While cancer incidence of adults with diabetes has been studied, overall national mortality trends remain sporadic. Methods: Cancer-related mortality data from 1999 to 2023 from the CDC WONDER database was analyzed retrospectively. Data included U.S. adults aged ≥ 65 years, ICD-10: E10 – E14 (diabetes) and ICD-10: C00 – D49 (neoplasm-related mortality). Age-adjusted mortality rates (AAMR) per 100,000 were calculated using the 2000 U.S. Standard Population – with annual percentage change (APC) determined regarding mortality trends. Results: Overall, there were 778,936 deaths from cancer among adults with diabetes (AAMR: 69.8). The total AAMR increased from 1999–2005 (+1.7%/year), and 2018–2021 (+10.3%/year), and the total AAMR decreased from 2005–2018 (–1.2%/year) and 2021–2023 (–2.6%/year). Men and Non-Hispanic American Indian/Alaskan Native individuals had the highest AAMRs. Non-Hispanic White and Hispanic individuals had slight increases till 2021 followed by declines. Among census regions, the South and Midwest had higher AAMRs. There were 1999-2007 and 2018-2020 increases in metro areas, while non-metropolitan areas showed rises in 1999–2003 and 2018–2020. Conclusions: Improvements in cancer care have not reduced cancer-related mortality for adults with diabetes. We observe discrepancies by race, age, region, etc. We need targeted prevention and equitable care for high-risk populations to decrease cancer mortality.