Trends in ethnic-specific colorectal cancer mortality in patients with and without diabetes in the United States: A CDC database population-based study 2011-2019.

Abstract

3545 Background: Colorectal cancer (CRC) is the third most frequent type of cancer and the second most lethal in both sexes combined. CRC is strongly associated with both environmental and genetic risk factors. Previous studies reported an increased mortality in CRC patients with diabetes mellitus, however, the interplay between ethnicity and diabetes mellitus was not explored. This study analyzes trends in mortality across ethnic groups and assess the impact of diabetes mellitus. Methods: We queried the Multiple Cause of Death database (International Classification of Diseases, 10th revision) between 2011 and 2019, we identified all patients (Hispanic and non-Hispanic origin) who died of a malignant neoplasm of the colon, rectosigmoid junction, and rectum {Codes C18.x to C20.x reported as the underlying cause of death (UCD)}. Then we identified the same group (UCD) among individuals with diabetes (Insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus) (Codes E10.x to E11.x reported as multiple causes of death). Age-adjusted mortality rates per million persons (PMP) were estimated, standardized to US census data from 2000, and stratified by Hispanic origin. Results: In the general population, a total of 464,058 deaths from CRC were identified, with an overall age- adjusted mortality rate of 137.9 PMP (Hispanic: 109.3, Non-Hispanic: 141.1). Overall, age-adjusted mortality declined by 13% among Hispanic, from 118.1 PMP in 2011 to 102.9 PMP in 2019, and by 8% among non-Hispanic, from 153.3 PMP in 2011 to 141.1 PMP in 2019. In the diabetic population, a total of 8679 CRC death were identified, with an overall age-adjusted mortality rate of 2.6 PMP (Hispanic: 3.6, Non-Hispanic: 2.5). Age-adjusted mortality increased by 32% in Hispanic from 3.1 PMP in 2011 to 4.1 PMP in 2019 and by 13% in non-Hispanic from 2.4 PMP in 2011 to 2.7 PMP in 2019. Conclusions: This study concludes that between 2011 and 2019, the CRC mortality was reduced in both Hispanic and non-Hispanic in the general population. Notably, this tendency was not observed in the diabetic population, where mortality increased, particularly among Hispanic. Additional studies are warranted to determine the causes of the rise among diabetics and strategies for minimizing the disparity between Hispanic and non-Hispanic. [Table: see text]