Centers For Disease Control Database Research Articles

Trends in pancreatic cancer mortality in the United States 1999-2020: a CDC database population-based study.

Pancreatic cancer is a significant public health concern and a leading cause of cancer-related deaths worldwide. This study aimed to investigate pancreatic cancer mortality trends and disparities in the United States (US) from 1999 to 2020. Data were obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research database. Mortality rates were age-adjusted and standardized to the year 2000 US population. Joinpoint regression was used to analyze temporal trends in age-adjusted mortality rates (AAMRs) by sociodemographic and geographic variables. Between 1999 and 2020, pancreatic cancer led to a total of 810,628 deaths in the US, an average mortality of nearly 39,000 deaths per year. The AAMR slightly increased from 10.6 in 1999 to 11.1 in 2020, with an associated annual percent change (APC) of 0.2. Mortality rates were highest among individuals aged 65 and older. Black individuals experienced the highest overall pancreatic cancer-related AAMR at 13.8. Despite this, Black individuals experienced a decreasing mortality trend over time (APC -0.2) while White individuals experienced an increasing trend in mortality (APC 0.4). Additionally, individuals residing in rural areas experienced steeper rates of mortality increase than those living in urban areas (APC 0.6 for rural vs -0.2 for urban). White individuals in urban and rural populations experienced an increase in mortality, while Black individuals in urban environments experienced a decrease in mortality, and Black individuals in rural environments experienced stable mortality trends. Mortality from pancreatic cancer continues to increase in the US, with racial and regional disparities identified in minorities and rural-dwelling individuals. These disparate findings highlight the importance of ongoing efforts to understand and address pancreatic cancer treatment and outcomes disparities in the US, and future studies should further investigate the underlying etiologies of these disparities and potential for novel therapies to reduce the mortality.

Increasing cancer-related mortality and demographic disparities in young adults in the United States between 1999 and 2020.

10569 Background: The global rise in cancer incidence in the young adult population (≤ 45 years), particularly in obesity-related cancers, is of growing concern. As the demographic afflicted by cancer expands beyond traditional boundaries, a nuanced understanding of the unique characteristics and challenges specific to young adults is imperative for developing interventions that address their distinct needs. In this study, we characterize cancer mortality rates in the young adult population to assess for emerging trends and cancer burden in the United States. Methods: The Centers for Disease Control database was queried for all underlying causes of death due to cancer (ICD 10 codes C00-C97) between 1999 and 2020. Malignancies that primarily affect the elderly, such as prostate and multiple myeloma, were excluded. Age-adjusted mortality (AAMR) rates per 100,000 people were extracted for adult patients between 25 and 44 years of age. AAMR was assessed by demographic and clinical variables, including race, geographic density, sex, and primary site. Joinpoint trend analysis was used to identify the presence of statistically significant temporal trends. Average annual percent change (AAPC) was considered statistically significant if p < 0.05. Results: Between 1999 and 2020, 366,478 cancer-related deaths occurred in young adults in the United States. The overall AAMR was 20.7, decreasing from 24.8 in 1999 to 17.5 in 2020 at a rate of -1.6% annually (p<0.05). However, increasing mortality was seen in a number of primary sites, including uterine cancer with an increase of 2.6% annually (p<0.05) and colorectal cancer with an increase of 0.8% annually (p<0.05). Overall AAMR was highest for non-Hispanic Black individuals at 28.3, 29% higher than the next highest group (non-Hispanic White) at 21.2 and almost double that of non-Hispanic Asians at 14.7. Individuals residing in rural populations experienced the highest AAMRs at 24.3 and the slowest rates of decrease at -1.6% annually (p<0.05), compared with urban individuals whose AAMR was 19.8 with a decrease of -1.9% annually (p<0.05). Primary sites with the highest AAMRs included breast (3.1), lung (2.1), and colorectal (1.8) cancers. Conclusions: The current study sheds light on the evolving landscape of cancer mortality among young adults in the United States. The overall decrease in age-adjusted mortality rates is promising, reflecting advancements in cancer care and prevention strategies. However, the alarming increase in mortality rates for specific cancer types, such as uterine and colorectal cancers, underscores the need for targeted interventions and heightened awareness, especially in at-risk populations. The identified racial and geographic disparities further emphasize the importance of implementing tailored approaches to address the unique challenges faced by diverse populations.

Temporal trends in hypertension related end stage renal disease mortality rates: an analysis of gender, race/ethnicity, and geographic disparities in the United States.

According to one USA Renal Data System report, 57% of end-stage renal disease (ESRD) cases are attributed to hypertensive and diabetic nephropathy. Yet, trends in hypertension related ESRD mortality rates in adults ≥ 35 years of age have not been studied. The aim of this retrospective study was to analyze the different trends hypertension related ESRD death rates among adults in the United States. Death records from the CDC (Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research) database were analyzed from 1999 to 2020 for hypertension related ESRD mortality in adults ≥ 35 years of age. Age-Adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, place of death, and geographic location. Hypertension-related ESRD caused a total of 721,511 deaths among adults (aged ≥ 35 years) between 1999 and 2020. The overall AAMR for hypertension related ESRD deaths in adults was 9.70 in 1999 and increased all the way up to 43.7 in 2020 (APC: 9.02; 95% CI: 8.19-11.04). Men had consistently higher AAMRs than woman during the analyzed years from 1999 (AAMR men: 10.8 vs women: 9) to 2020 (AAMR men: 52.2 vs women: 37.2). Overall AAMRs were highest in Non-Hispanic (NH) Black or African American patients (45.7), followed by NH American Indian or Alaska Natives (24.7), Hispanic or Latinos (23.4), NH Asian or Pacific Islanders (19.3), and NH White patients (15.4). Region-wise analysis also showed significant variations in AAMRs (overall AAMR: West 21.2; South: 21; Midwest: 18.3; Northeast: 14.2). Metropolitan areas had slightly higher AAMRs (19.1) than nonmetropolitan areas (19). States with AAMRs in 90th percentile: District of Columbia, Oklahoma, Mississippi, Tennessee, Texas, and South Carolina, had roughly double rates compared to states in 10th percentile. Overall hypertension related ESRD AAMRs among adults were seen to increase in almost all stratified data. The groups associated with the highest death rates were NH Black or African Americans, men, and populations in the West and metropolitan areas of the United States. Strategies and policies targeting these at-risk groups are required to control the rising hypertension related ESRD mortality.

Longitude-based time zone partitions and rates of suicide

BackgroundIncreasing evidence suggests that conditions with decreased morning and increased evening light exposure, including shift work, daylight-saving time, and eveningness, are associated with elevated mortality and suicide risk. Given that the alignment between the astronomical, biological, and social time varies across a time zone, with later-shifted daylight exposure in the western partition, we hypothesized that western time zone partitions would have higher suicide rates than eastern partitions. MethodsUnited States (U.S.) county-level suicide and demographic data, from 2010 to 2018, were obtained from a Centers for Disease Control database. Using longitude and latitude, counties were sorted into the western, middle, or eastern partition of their respective time zones, as well as the northern and southern halves of the U.S. Linear regressions were used to estimate the associations between suicide rates and time zone partitions, adjusting for gender, race, ethnicity, age group, and unemployment rates. ResultsData were available for 2872 counties. Across the U.S., western partitions had statistically significantly higher rates of suicide compared to eastern partitions and averaged up to two additional yearly deaths per 100,000 people (p < .001). LimitationsEcological design and limited adjustment for socioeconomic factors. ConclusionsTo our knowledge, this is the first study of the relationship between longitude-based time zone partitions and suicide. The results were consistent with the hypothesized elevated suicide rates in the western partitions, and concordant with previous reports on cancer mortality and transportation fatalities. The next step is to retest the hypothesis with individual-level data, accounting for latitude, photoperiodic changes, daylight-saving time, geoclimatic variables, physical and mental health indicators, as well as socioeconomic adversity and protection.

Colorectal cancer mortality in young adults in the United States.

e15530 Background: Colorectal cancer (CRC) is typically considered a disease that affects older adults. However, recently a concerning increase in the incidence rates of CRC among young adults (age &lt; 50) has been noted. Given the limited analysis of colorectal cancer mortality assessing for age-based differences, we aimed to characterize trends in mortality rates of CRC between 1999 and 2020 in the United States, with the hypothesis that younger patients would also experience an increasing morality rate from CRC in concert with the increasing incidence. Methods: We queried the Centers for Disease Control database for mortality statistics with an underlying cause of death of colon and rectal cancer between the years 1999 - 2020. Crude mortality rates (CMR) were calculated per 100,000 deaths. Patients were stratified based on early-onset (30-49 years), average-onset (50-69 years), and late-onset (70+ years) CRC. For each cohort, we examined race and U.S. Census Region variables to assess drivers in mortality. Temporal trends were assessed using Joinpoint regression software. Average annual percent change (AAPC) were considered statistically significant if p &lt; 0.05. Results: Between 1999 and 2020, 1,166,158 deaths due to CRC occurred and the CMR decreased from 20.3 to 15.7. For patients aged &gt; 70, colorectal cancer mortality rate decreased from 148.6 to 75.9 at an average of 3.2% annually during this time frame. For the group aged 50-69, there was a decrease in CMR from 32.7 to 24.2, reflecting an average annual decrease of1.4%. In patients aged 30-49, CMR increased from 3.6 to 4.2, reflecting an average annual percent increase in mortality of 0.7%. This increase in CRC mortality in the youngest cohort occurred independent of geographical location. Mortality in young adults increased the fastest in the West at a rate of 1.1% annually and slowest in the South at 0.4% annually. Similar increases in mortality rates were identified when cohorts were stratified by race, with Non-Hispanic American Indian/Native American populations experiencing the most rapid increases in mortality at 3.4% annually. Conclusions: These results demonstrate age-related disparities in recent CRC mortality trends. While the overall mortality of CRC has decreased over the last two decades, this decrease was largely due to declining mortality in older adults. In contrast, younger adults experienced a sharp rise in CRC mortality rates, increasing at an average annual percentage increase of almost 1% each year independent of racial or geographic factors. These results highlight a concerning emerging trend with significant public health implications and provide rationale for increased surveillance in young adults.

Demographic disparities in lung cancer mortality and trends in the United States between 1999 and 2020: A population-based CDC database analysis.

6603 Background: Lung cancer is the leading cause of cancer-related mortality in the US and is projected to account for 127,070 deaths in 2023. While the lung cancer mortality rate has been decreasing over the last decade, demographic disparities in mortality still exist. We sought to determine the impact of demographic factors on lung cancer mortality and trends in the US. Methods: We queried the Centers for Disease Control database for mortality statistics with an underlying cause of death of lung and bronchus cancer (ICD-10 code C34.0.x) between the years 1999 – 2020. Age-adjusted mortality rates (AAMR) were calculated per 100,000 deaths. We assessed the AAMR by demographic variables, including race (Hispanic, Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian or Pacific Islander, Non-Hispanic American Indian/Native American), geographic density (Urban, Suburban, Rural), sex, age (25-44, 45-64, 65+ years), and US Census Region. Temporal trends were evaluated using Joinpoint regression software. Average annual percent change (AAPC) was considered statistically significant if p &lt; 0.05. Results: Between 1999 and 2020, lung cancer led to 3,380,830 deaths. The AAMR decreased by 42% from 55.1 to 31.8 with an associated AAPC of -2.6% (p &lt; 0.001). In 1999, men had an AAMR of 76.8, almost twice as high as women, who had an AAMR of 40.2. These differences became less pronounced over time, and in 2020 men had an AAMR of 38.1, while women had an AAMR of 26.9. Between 1999 and 2020, rural populations experienced the highest AAMR at 52.3, and the slowest rate of decrease at -1.7% annually (p &lt; 0.001), compared with urban populations who experienced the lowest AAMR of 40.6 and fastest AAPC decrease of -3.1% (p &lt; 0.001). Non-Hispanic Black individuals experienced the highest AAMR at 49.8, with an annual decrease of -3.0% (p &lt; 0.001), followed by Non-Hispanic White individuals who had an AAMR of 48.5 with an annual decrease of -2.5% (p &lt; 0.001). Subgroup analysis demonstrated that Non-Hispanic Black men who resided in rural counties experienced the highest mortality at 60.2, with an associated decrease of -2.9% annually (p &lt; 0.001). States in the 90th percentile of mortality included Arkansas and Kentucky; states in the 10th percentile of mortality included Hawaii and Utah. The West experienced the fastest decrease at -3.1% annually (p &lt; 0.001), while the Midwest experienced the slowest decrease at -2.0% annually (p &lt; 0.001). Conclusions: While lung cancer mortality has been decreasing since 1999, not all demographic groups have experienced the same rates of decline, and disparities in outcomes remain prevalent. Vulnerable subgroups may benefit from targeted interventions, such as tailored smoking cessation education and efforts to increase participation in clinical trials. Expansion of screening CT scans and telehealth platforms may also improve access to care for these populations.

Suicidal Ideation Among Patients with Gastrointestinal Cancer.

Mental illness (MI) and suicidal ideation (SI) often are associated with a diagnosis of cancer. We sought to define the incidence of MI and SI among patients with gastrointestinal cancers, as well as ascertain the predictive factors associated with SI. Patients diagnosed between 2004 and 2016 with stomach, liver, pancreatic, and colorectal cancer were identified from the SEER-Medicare database. County-level social vulnerability index (SVI) was extracted from the Centers for Disease Control database. Multivariable logistic regression was used to identify factors associated with SI. Among 382,266 patients, 83,514 (21.9%) individuals had a diagnosis of MI. Only 1410 (0.4%) individuals experienced SI, and 359 (0.1%) committed suicide. Interestingly, SI was least likely among patients with pancreatic cancer (ref: hepatic cancer; odds ratio [OR] 0.67, 95% confidence interval [CI] 0.52-0.86; p = 0.002), as well as individuals with stage III/IV disease (OR 0.59, 95% CI 0.52-067; p < 0.001). In contrast, male (OR 1.34, 95% CI 1.19-1.50), White (OR 1.34, CI 1.13-1.59), and single (OR 2.03, 95% CI 1.81-2.28) patientswere at higher odds of SI risk (all p < 0.001). Furthermore, individuals living in relative privilege (low SVI) had markedly higher risk of SI (OR 1.33, 95% CI 1.14-1.54; p < 0.001). Moreover, living in a county with a shortage of mental health professionals was associated with increased odds of developing SI (OR 1.21, 95% CI 1.04-1.40; p = 0.012). Oncology care teams should incorporate routine mental health and SI screening in the treatment of patients with gastrointestinal cancers, as well as target suicide prevention towards patients at highest risk.

The molecular determination of &lt;i&gt;emm&lt;/i&gt; genotypes in non-group a beta-hemolytic streptococci isolated from clinical samples

Objective: M protein is an important marker in epidemiological and phylogenetic surveillance of Beta-Hemolytic Streptococci. The aim of this study is to determine emm types and their distribution among the GCS/GGS strains isolated from clinical samples. Material and methods: The study includes 98 β-hemolytic streptococcus strains isolated from clinical samples in Çukurova University/Balcalı Hospital. 67 of these isolates, defined as serologic, of which 56 were identified as Streptococcus dysgalactiae subsp. equisimilis, 8 as S. anginosus and 3 as S.equi subsp.zooepedimicus, have been included in the study. These strains were also confirmed by the Vitek 2GP-ID system. These isolates were confirmed by the polymerase chain reaction (PCR) method with primers based on groESL sequences. PCR-sequence analysis method developed by the Centers for Disease Control (CDC) was used for typing according to emm polymorphism. Results: 56/67 (83.6%) isolates in which emm-PCR was determined as positive were typed by sequence analysis. The findings were identified using the CDC database, and the most common type was determined to be stG485 (51.85%), stG643 (12.96%) and stG6 (9.25%). Conclusion: Consequently, GCS/GGS should be treated more seriously in our country as in the whole world.

Laboratory Markers and Mortality in Novel Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

Abstract Background Novel coronavirus disease 2019 (COVID-19) is associated with high mortality. Many laboratory values have been suggested to predict patients at risk for a poor outcome in COVID-19.The objective of this project was to systematically review and meta-analyze all laboratory markers associated with prognosis of mortality in patients with COVID-19. Methods We searched OVID Medline, SCOPUS, MedRxIv, preprints.org, and Centers for Disease Control databases from November 2019 to April 10, 2020 for articles on laboratory values and mortality in COVID-19 and updated the search July 20, 2020. Teams of 2 independent reviewers reviewed titles and abstracts for studies that reported mortality and laboratory values and subsequently abstracted relevant data. Results Our initial search identified 6,973 articles and a total of 96 articles (30 articles from first search and 66 from updated search) on 72 laboratory values were included. Many laboratory values were associated with mortality, but those most associated with mortality included lymphopenia (OR 0.30, 95% CI 0.24-0.36), thrombocytopenia (OR 0.46, 95% CI 0.35-0.60), elevated lactate dehydrogenase (OR 7.32, 95% CI 5.19-10.33), and ferritinemia (OR 5.19, 95% CI 3.07-8.62). All cardiac markers were associated with mortality, with troponin being the least associated. A low PaO2:FiO2 ratio was also associated with mortality (OR 0.13, 95% CI -0.06-0.28). Heterogeneity was high and risk of bias was moderate. Conclusions This meta-analysis identified many laboratory abnormalities associated with mortality in COVID-19, though was limited by heterogeneity. Laboratory markers previously identified as associated with a poor prognosis in COVID-19 were confirmed to be those most associated with mortality in this large meta-analysis.

Epidemiologic Characteristics of Domestic Patients with Hemorrhagic Fever with Renal Syndrome in Taiwan: A 19-Year Retrospective Study.

Background: Hemorrhagic fever with renal syndrome (HFRS) is an illness caused by hantaviruses. Numerous factors modify the risk of hantavirus transmission. This study explored the epidemiological characteristics, differences, and trends in terms of gender, age, season, and living areas of those diagnosed with domestically acquired HFRS in Taiwan from 2001 to 2019. Methods: We examined publicly available annual summary data on the domestic cases with HFRS from 2001 to 2019; these data were obtained from the web database of Taiwan’s Centers for Disease Control (CDC). Results: This study analyzed 21 domestic cases with HFRS from Taiwan’s CDC databases. In this study of the cases of HFRS in Taiwan, a gradual increase in the cases of those aged ≥40 years acquiring the disease was noted, and a distinct pattern of seasonal variation (spring) was observed. Furthermore, more men had domestically acquired HFRS, and living in Taipei metropolitan area (6 cases [28.6%]) and the rural areas (Gao-Ping region, 9 cases [42.9%]) was identified as a potential risk factor. This study represents the first report of confirmed cases of domestically acquired HFRS from surveillance data from Taiwan’s CDC, 2001–2019. Conclusion: This study highlights the importance of longitudinal studies covering a wide geographical area, particularly for highly fluctuating pathogens, to understanding the implications of the transmission of zoonotic diseases in human populations. Important data were identified to inform future surveillance and research efforts in Taiwan.