Colorectal cancer and sepsis mortality among the elderly: Analysis from 1999 to 2020.

Abstract

e15592 Background: Sepsis is a major cause of death among adults, especially those with colorectal cancer, a common cancer in older individuals. Despite healthcare advances, studies have noted a rising trend in severe sepsis-related colorectal cancer mortality since 2016, emphasizing the importance of exploring its long-term patterns and disparities. Methods: Analysis was conducted using data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) database from 1999 to 2020. Cases were identified using ICD-10 codes for sepsis (A40.0–A41.9) and colorectal cancer (C18.0–C20). Crude and age-adjusted mortality rates (AAMRs) per 100,000 populations were calculated for adults aged 65 and older. Joinpoint regression was used to estimate the annual percent change (APC) and average annual percent change (AAPC), with 95% confidence intervals (CIs). Mortality disparities were assessed by age, gender, race/ethnicity, metropolitan/non-metropolitan, and census region. Results: Between 1999 and 2020, 33,291 deaths in the U.S. were attributed to colorectal cancer and sepsis. There was a decline in mortality rate from 1999 to 2020 with an AAPC of -2.06 (95% CI: -2.35 to -1.76). The AAMR itself declined from 4.54 in 1999 to 2.92 in 2020 (AAPC: -2.06; 95% CI: -2.35 to -1.76). Mortality rates increased with age, with the highest CMR in individuals aged 85+ years (6.43) and the lowest in those aged 65–74 years (2.39). Males had a higher AAMR (4.58) than females (2.95), though females observed a greater decline (AAPC: -2.32; 95% CI: -2.71 to -1.92) than males (AAPC: -1.99; 95% CI: -2.23 to -1.74). AAMRs were similar among Hispanic (3.62) and non-Hispanic (3.63) populations. Among non-Hispanics, Black or African Americans had the highest AAMR (5.58) and the greatest decline in mortality (AAPC: -2.67; 95% CI: -3.43 to -1.92). The Northeast had the highest AAMR (3.853) with the steepest decline (AAPC: -3.48; 95% CI: -3.92 to -3.06), while the West saw the slowest decline (AAPC: -1.04; 95% CI: -1.76 to -0.34). Metropolitan areas experienced a greater decline (AAPC: -2.29; 95% CI: -2.60 to -1.96) than non-metropolitan areas (AAPC: -0.93; 95% CI: -1.46 to -0.36), with AAMRs dropping from 4.60 to 2.80 and 4.18 to 3.17, respectively. Conclusions: Although sepsis-related colorectal cancer mortality declined among adults aged 65 and older from 1999 to 2020, significant demographic and geographic disparities persist. Targeted interventions are needed to address disparities and slower declines in specific population groups.