Why the study?
Few large-scale epidemiologic studies have evaluated sudden cardiac death trends and disparities among colorectal cancer patients.
While sudden cardiac death rates among colorectal cancer patients have declined over two decades, persistent disparities by sex, race, and geography highlight the need for targeted cardio-oncology surveillance.
May support targeted cardio-oncology surveillance in colorectal cancer; leaves open drivers of sex, race, and geographic disparities.
BACKGROUND: Colorectal cancer (CRC) patients are at risk of cardiovascular problems, especially sudden cardiac death, due to aging, pre-existing comorbidities, and cardiotoxic medicines. Few large-scale epidemiologic studies on SCD trends and disparities in CRC patients exist. The goal is to examine US CRC decedent SCD trends and sociodemographic variations from 1999 to 2020. METHODS: A retrospective population-based analysis was conducted using the CDC WONDER Multiple Cause of Death database (1999-2020). Colorectal cancer (CRC) fatalities were identified using ICD-10 codes C18-C21, and sudden cardiac death (SCD) was defined using ICD-10 codes I46.1, I46.9, R96.0, I49.0, and I21-I24. Age-adjusted and crude death rates were estimated by sex, race/ethnicity, age group, and U.S. state. Temporal trends were assessed using linear regression. Subgroup analyses were also performed by age, sex, and geographic region. RESULTS: The age-adjusted mortality rate of SCD among CRC decedents reduced from 1.2 to 0.5 per 100,000 population between 1999 and 2020, demonstrating a steady trend. Males had greater SCD rates than females for two decades. Age-stratified analysis showed that CRC patients aged 65-84 carried the most SCD burden. Race and ethnicity affected SCD mortality, with Black and Asian/Pacific Islanders dying more than Whites. Geographic study found high SCD rates in Nebraska and Vermont and low rates in California and Texas. CONCLUSIONS: Despite age-adjusted rate decreases over two decades, SCD remains a significant contributor to death in CRC patients. Persistent discrepancies by gender, race, and geography underline the importance of individualized cardio-oncology surveillance, equitable preventative initiatives, and focused public health interventions.
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Sanji et al. (2025) studied this question.
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