Trends and disparities in colorectal cancer among adults with diabetes mellitus in the United States: A retrospective analysis, 1999-2023.

Abstract

e15674 Background: Colorectal cancer (CRC), the fourth leading cause of cancer-related deaths, affects approximately 1.5 million U.S. adults and is increasingly linked to diabetes. Diabetic patients face elevated mortality due to delayed detection, higher recurrence risk, reduced five-year survival, and poorer prognosis. This study assesses recent demographic trends in CRC mortality with diabetes as a contributing factor. Methods: We analyzed mortality data from the CDC WONDER Multiple Cause-of-Death dataset, using ICD-10 Codes: C18; C19; C20, and E10-E14. Age-adjusted mortality rates (AAMR) per 1,000,000 individuals and annual percentage changes (APC) were calculated by year, gender, race or ethnicity, and location. Results: Between 1999 and 2023, 79,568 deaths occurred from colorectal cancer in diabetic adults. The AAMR declined from 16.94 in 1999 to 13.01 in 2023 (AAPC: -1.15; 95%CI: -1.44 to -0.87). Males showed a higher AAMR of 17.17 versus 9.73 in females. Non-Hispanic (NH) Black or African American individuals had the highest AAMR (19.77), followed by Hispanic or Latino (14.23), NH White (12.48), and NH Asian or Pacific islander (9.29). AAMRs in non-metropolitan (18.52) areas were higher than in Metropolitan areas (13.49). The Midwest region exhibited the highest AAMR, followed by the South, West, and Northeast regions. State-level differences recorded Oklahoma having the highest AAMR (32.81) and Massachusetts the lowest (5.16). Conclusions: Mortality related to colorectal cancer in diabetic adults has declined significantly over the past two decades, disproportionately affecting non-Hispanic Black individuals, residents of non-metropolitan areas and the Midwest region. This emphasizes the need for targeted interventions and greater clinical sensitivity to demographic disparities. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for colorectal cancer related mortality among diabetic adults in the United States from 1999 to 2023. Variable Deaths (n) AAMR (95% CI) Overall 79,568 13.01 (12.58 to 13.44) SEX Male 43,494 17.17 (16.42 to 17.91) Female 36,074 9.73 (9.23 to 10.23) RACE/ETHNICITY NH Blacks 11,535 19.77(18.10 to 21.45) Hispanics 6,233 14.23(12.80 to 15.65) NH White 59,929 12.48(12.02 to 12.95) NH Asians 2,199 9.29 (7.72 to 10.87)