Trends and Disparities in Cancer-Related Mortality Among Adults With Diabetes in the United States: 1999–2019

Aim

Cancer and diabetes are major public health concerns, with diabetes linked to increased cancer-related mortality. However, national trends and disparities remain underexplored.

Methods

Using CDC WONDER data, we analysed deaths where both diabetes and cancer were listed as causes. Age-adjusted mortality rates (AAMRs) were calculated for diabetic cancer patients aged ≥ 25 years and stratified by demographics and geography. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs).

Results

From 1999 to 2019, 699,007 cancer-related deaths occurred among individuals with diabetes. The overall AAMR increased from 15.06 to 15.23 per 100,000 (AAPC: +0.07%; p = 0.20), with a rise from 1999 to 2003, a decline from 2003 to 2015, and a resurgence from 2015 to 2019. Men (AAMR: 20.83) had higher mortality than women (AAMR: 11.80). Non-Hispanic Black individuals had the highest AAMRs (23.72), but NH American Indian/Alaska Natives had the largest increase (AAPC: 0.60). The Midwest (AAMR: 17.03) and rural areas (AAMR: 18.70) had the highest mortality, with rural rates rising significantly (AAPC: 0.92). Gastrointestinal cancers were the leading cause (AAMR: 4.31), followed by haematological (AAMR: 1.80), prostate (AAMR: 1.59), and breast cancer (AAMR: 1.38).

Conclusion

Cancer-related mortality in individuals with diabetes has increased, with notable disparities. Targeted interventions, screening, and better diabetes management are essential to reducing risks in high-risk populations.