Abstract P354: Trends in Malignancy and Cardiovascular Disease Related Mortality in the United States

Abstract

Introduction: In the United States (US), malignancy and cardiovascular disease (CVD) make up the majority of the burden of chronic diseases, leading to greater morbidity and mortality. As the general population grows older, the prevalence of these two disease entities are likely to increase. Efforts in cardio-oncology have been focused on disease prevention and treatment, however, little is known about existing disparities in this population. Hypothesis: Unequivocal burden of CVD-related mortality exists among certain gender, racial, and geographic subgroups. Methods: Data was obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database using death certificate information from the National Vital Statistics system. All CVD-related death (I00 - I78) as the underlying cause of death in individuals with malignancy (C00 - C97) as the multiple causes of death were queried from 1999 - 2020. Underlying cause of death was defined as the disease that directly led to death and the multiple causes of death were defined as the diseases that contributed to death. Quantified measures included age-adjusted mortality rate (AAMR) per 100,000 population, 95% confidence intervals, and average annual percentage change (AAPC). Joinpoint regression (National Cancer Institute) was utilized for trend analysis and AAPC calculation. Results: There was a total of 595,446 deaths between 1999 and 2020. The AAMR in 1999 was 24.85 which decreased to 12.811 by 2020 (p <0.05), with an AAPC of -3.1%. Males (23.14) had a higher AAMR compared to females (11.05) (p <0.05), and AAPC for both males and females were -3.4%. AAMR was disproportionately higher in non-Hispanic populations (16.26) compared to Hispanic populations (9.17) (p <0.05), with similar AAPC (-3.1% and -3.0%, respectively [p >0.05]). Black individuals (18.87) had the highest AAMR, followed by White individuals (15.81), American Indian/Alaska Native individuals (9.40), and Asian/Pacific Islander individuals (8.26) (p <0.05). All AAPC for the racial subgroups were similar (-3.3%, -3.1%, -2.7%, and -4.1%, respectively [p >0.05]). Non-metro regions (17.20) had higher AAMR compared to metro regions (15.54) (p <0.05) with an AAPC of -2.4 and -3.3%, respectively (p >0.05). The Northeast (17.93) had the highest AAMR, followed by similar AAMR in the Midwest (16.44) and West (16.30) regions, and then South regions (13.98) (p <0.05). AAPC was similar among all US census regions (-3.6%, -3.3%, -3.4%, and -2.8%, respectively [p >0.05]). Conclusion: Even with decreasing rates of AAMR from 1999 to 2020, there remains a disproportionate burden of AAMR among gender, racial, and geographic subgroups. Continued efforts targeted at mitigating CVD-related mortality in patients with underlying malignancy is warranted.