Racial and regional disparities in prostate cancer–associated dementia mortality in the United States, 1999–2020: A CDC WONDER analysis.

Abstract

e17023 Background: As prostate cancer (PC) survival improves, age-related comorbidities, including dementia, increasingly contribute to mortality among affected individuals. However, national patterns and disparities in prostate cancer and dementia related mortality remain poorly characterized. Our study aims to use a publicly available database to evaluate disparities in PC and dementia-related mortality by region of the United States (U.S.) and race, between 1999 and 2020. Methods: We conducted a retrospective, population-based analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database from 1999 to 2020. We extracted data for U.S. adults from 1999 to 2023 who died with prostate cancer (ICD-10: C61) and dementia (ICD-10: F03) as a contributing cause. Age-adjusted mortality rates (AAMRs) were standardized to the 2000 U.S. population. Demographic data, including the census region, race, and year of death, were collected. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population. Analyses were conducted using R version 4.1.1. Results: A total of 43,441 individuals died with prostate cancer and dementia between 1999 and 2020. Of those, 6561 (15.1%) were Black or African American, 36,477 (84%) were White, and 403 (0.9%) were Asian or Pacific Islander. Prostate cancer and dementia combined caused an overall AAMR of 0.65 (CI 0.55, 0.73) between 1999 and 2020. The AAMR for the Northwest region was 0.60 (CI 0.51, 0.70). The AAMR for the Midwest region was 0.70 (CI 0.61, 0.79). The AAMR for the South region was 0.66 (CI 0.58, 0.73). The AAMR was 0.60 (CI 0.49, 0.68) for the Western Region. When classifying data by race, the overall AAMR for Black or African American persons was 1.15 (CI 0.92, 1.42), White persons had an AAMR of 0.56 (CI 0.50, 0.62), and Asian and Pacific Islander persons had an AAMR of 0.3 (CI 0.16, 0.45). Over time, the AAMR increased in all four regions when comparing the year 1999 to the year 2020. The AAMR increased over time for White and Black or African American persons, comparing the year 1999 to the year 2020, but decreased in Asian or Pacific Islander persons, comparing the year 1999 to the year 2020. Conclusions: Between 1999 and 2020, the Midwest and South had higher AAMRs from prostate cancer and dementia than patients in the Northeast or West regions of the United States. Regarding racial differences, Black or African American persons experienced higher AAMRs than their White or Asian and Pacific Islander counterparts. Our findings call for better public health awareness and care for those with prostate cancer and dementia.