Non-Hodgkin lymphoma and diabetes-related mortality in the United States, 1999-2023: A CDC WONDER analysis.

Abstract

e19091 Background: Individuals with diabetes mellitus and non-Hodgkin lymphoma (NHL) experience substantially higher morbidity and mortality. This study assessed long-term patterns in diabetes-related mortality among patients with NHL in the United States from 1999 to 2023, stratified by age, sex, race/ethnicity, urban–rural status, and geographic region. Methods: Mortality data for adults aged ≥45 years with NHL and diabetes mellitus from 1999–2023 were obtained from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals. Analyses were stratified by sex, race/ethnicity, census region, urbanization status, and age group. Results: Between 1999 and 2023, 61,358,342 U.S. adults aged ≥45 years died, including 30,217,781 men (49.24%) and 31,140,551 women (50.75%). Overall AAMRs for diabetes-related mortality among patients with NHL showed a modest, non-significant increase (AAPC 0.78%; 95% CI −0.42 to 1.99; p=0.20). In sex-stratified analyses, males exhibited a significant upward trend (AAPC 1.47%; 95% CI 0.42–2.52; p=0.006), whereas females showed no significant change (AAPC −0.16%; 95% CI −2.18 to 1.89; p=0.87). All census regions demonstrated increasing trends, with the largest rises observed in the South and West. Mortality increases were more pronounced in metropolitan areas, with rates nearly threefold higher than in non-metropolitan areas over the study period. Rising trends were observed across racial and ethnic groups, including Hispanic and non-Hispanic Black populations, with the greatest increases among non-Hispanic White individuals. Conclusions: Diabetes-related mortality among U.S. adults with non-Hodgkin lymphoma has increased over the past decade, despite broader declines in cancer mortality. Disproportionate increases among men, metropolitan residents, and specific racial and ethnic groups highlight important disparities. These findings underscore the need for integrated oncologic and metabolic care strategies and targeted interventions in high-risk populations.