e13091 Background: Breast cancer is the most commonly diagnosed cancer and a leading cause of cancer-related mortality among women in the United States. Mental and behavioral disorders (MBDs) are increasingly recognized as contributors to disparities in cancer screening, treatment adherence, and survival. However, population-level, age-stratified patterns of MBD-associated breast cancer mortality remain poorly characterized. Methods: We analyzed age-adjusted mortality rates (AAMRs) per 100,000 population using the CDC WONDER database (1999–2023) for breast cancer (ICD-10: C50) deaths with co-occurring mental and behavioral disorders (ICD-10: F01–F99). Joinpoint regression models were applied to estimate annual percent change (APC) and identify significant temporal trends. Results: From 1999 to 2023, a total of 107627 deaths were reported among breast cancer patients with mental and behavior disorders. The overall AAMR increased from 0.9 in 1999 to 2.4in 2023 (AAPC: 3.74; 95% CI: 2.98 to 4.52; p < 0.001). The most pronounced increase was observed between 1999 and 2006 (APC: 8.29; 95% CI: 5.57 to 11.08; p < 0.001), followed by a continued and marked rise through 2023 (APC: 1.93; 95% CI: 1.52 to 2.33; p < 0.001). Older adults accounted for the majority of deaths (n = 89,974). Women consistently demonstrated a higher annual increase in mortality compared with men (AAPC: 4.11% vs. 0.00%). The highest AAMRs were observed among non-Hispanic Black and non-Hispanic White individuals, while the lowest rates occurred among Hispanic individuals; however, non-Hispanic White individuals exhibited the highest AAPC (3.96%). Geographic disparities were evident, with the South experiencing the greatest increase in mortality and the West the least. Metropolitan areas showed a steeper rise compared with non-metropolitan areas. Conclusions: This national, age-stratified analysis reveals a disproportionate burden of breast cancer mortality among individuals with co-occurring mental and behavioral disorders, particularly in older age groups. These disparities likely reflect gaps in screening, timely diagnosis, treatment access, and continuity of care. Average Annual Percentage Change (AAPC) per 100,000 population for trends in breast cancer and mental and behaviour disorders from 1999 to 2023. Variable AAPC (95%CI) P-Value Overall 3.74( 2.97– 4.52) < 0.000001 Male 0 < 0.000001 Female 4.10( 2.70– 5.52) < 0.000001 NH Blacks 3.88( 2.85 – 4.92) < 0.000001 Hispanic 3.36( 2.51– 4.23) < 0.000001 NH White 3.96( 3.08– 4.86) < 0.000001 West 3.40 (1.53 to 5.30) = 0.000319 Northeast 3.45 (2.59 to 4.32) < 0.000001 South 4.61(3.56 to 5.68) < 0.000001 Midwest 3.78(2.97 to 4.60) < 0.000001 Metropolitan areas 3.75(2.74 to 4.77) < 0.000001 Non metropolitan areas 5.16(3.78 to 6.56) < 0.000001
Arif et al. (Thu,) studied this question.