Key result
Mortality in older adults with concurrent HF and colon cancer rises ~3% annually after 2015.
Why the study?
Heart failure and colorectal cancer are major public health concerns among the aging US population, prompting investigation of temporal, regional, urbanization, and racial mortality trends in older adults.
Observational (n=49,917)
Effect estimate: APC 2.55 (95% CI 0.08 to 8.19)
p-value: p=<0.05
Mortality rates from concomitant heart failure and colon cancer in older US adults declined significantly until 2015 but have recently begun to resurge, with notable demographic and geographic disparities identifying vulnerable populations for targeted interventions.
Mortality reversal since 2015 in older adults with HF and colon cancer warrants monitoring; leaves open drivers of the uptick and disparities.
Background: Heart failure (HF) and colorectal cancer (CRC) are major public health concerns among the aging population in the United States. This study aimed to investigate temporal, regional, urbanization and racial trends in mortality among adults with HF and CRC aged ≥65 years. Methods: Mortality data were sourced from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, utilizing ICD-10 codes to identify deaths related to colon cancer and heart failure from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated, along with Annual Percentage Changes (APCs) and their respective 95 % confidence intervals (CIs). Results: The AAMRs remained relatively stable between 1999 (8.5) and 2004 (7.3) (APC: -2.61; 95 % CI: -3.86, 0.09). From 2004 to 2009, a significant decline to 5.0 was observed (APC: -7.08; 95 % CI: -9.28, -3.58). Subsequently, the rates stabilized by 2015 (3.8) (APC: -4.84; 95 % CI: -6.58 to 2.04) but demonstrated a modest increase to 4.4 by 2020 (APC: 2.55; 95 % CI: 0.08 to 8.19). Mortality rates were consistently higher among males (6.7 vs. 4.5 for females) and varied across racial/ethnic groups, with Non-Hispanic (NH) Whites (5.7) and NH Black/African Americans (5.4) exhibiting the highest rates, while Hispanics (2.8) and NH Asians/Pacific Islanders (2.3) had the lowest. Regional disparities showed that the Midwest had the highest AAMRs (6.5) followed by the Northeast (5.4), West (5.2), and South (4.8). Additionally, non-metropolitan areas exhibited significantly higher rates than metropolitan areas (7.1 vs. 5.0, respectively). The states in the 90th percentile for AAMRs were West Virginia, Mississippi, South Dakota, Nebraska, and North Dakota. Conclusion: Although there was an overall decline in mortality rates during the study period, disparities remained evident, with higher mortality observed among males, non-Hispanic Whites, residents of the Midwest, and individuals in non-metropolitan areas. This highlights the need for targeted public health intervention.
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Rahman et al. (2025) conducted an observational in Concurrent heart failure and colon cancer (n=49,917). Time period (1999-2020) was evaluated on Annual Percentage Change (APC) in Age-Adjusted Mortality Rate (AAMR) (APC 2.55, 95% CI 0.08 to 8.19, p=<0.05). Age-adjusted mortality rates for concurrent heart failure and colon cancer in U.S. adults aged ≥65 years declined from 2004 to 2015, but subsequently demonstrated a significant increase by 2020 (APC 2.55).
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