What is the clinical evidence from this study?

Study design: Cohort. Population: Pulmonary embolism in cancer patients (n=214756). Primary outcome: Age-adjusted mortality rate (AAMR) per 100,000 persons (AAPC 1.93, 95% CI 1.72 to 2.13, p=≤0.05).

July 16, 2025Open Access

Trends in pulmonary embolism mortality in cancer patients in the United States from 1999-2022– A CDC Wonder database study

Key Result

Pulmonary embolism-related age-adjusted mortality in US cancer patients increased from 3.42 to 5.38 per 100,000 persons between 1999 and 2022, with an average annual percent change of 1.93.

Study Design

Type

Cohort (n=214,756)

Structured PICO

Population

Adults ≥25 years with cancer who died with pulmonary embolism as a contributing cause in the United States between 1999 and 2022 (n=214,756 deaths).

Outcome

Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) and average annual percent changes (AAPCs) of PE-related mortalityhard clinical

Pulmonary embolism-related mortality in cancer patients in the US increased significantly from 1999 to 2022, with a notable acceleration starting in 2016, particularly affecting males, Black patients, older adults, and rural populations.

Main Result

Effect estimate: AAPC 1.93 (95% CI 1.72 to 2.13)

Absolute Event Rate: 5.38% vs 3.42%

p-value: p=≤0.05

Limitations

Potential underestimation of mortality rates due to dependence on accurate reporting and coding of death certificates
Dataset does not include information related to cancer type, family prevalence of PE, or other patient comorbidities

Abstract

BACKGROUND: Pulmonary embolism (PE) is the third leading cause of cardiovascular death in the United States (Thromb Res. 2023;223:53-60) and presides as a major cause of morbidity and mortality among cancer patients. We investigated the trends of PE-related mortality in cancer patients over the last two decades. METHODS: This retrospective analysis of the Centers for Disease Control's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database focused on PE-related mortality in cancer patients across the United States from 1999 to 2022. Mortality in adults with PE and cancer was analyzed. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) and average annual percent changes (AAPCs) were calculated and reported. RESULTS: There were 214,756 total deaths due to PEs in cancer patients in the United States between 1999-2022. The overall mortality trend increased over time, with an annual percent change increase from 0.61 (95% CI 0.29 to 0.88)* from 1999-2016 to 5.77 (95% CI 4.68 to 7.41)* in 2016-2022 and an average annual percent change (AAPC) of 1.93 (95% CI 1.72 to 2.13). A notable mortality increase was seen across gender, race/ethnicity, age, and regional factors beginning in 2016 and continuing through 2022. Additionally, PE-related mortality was significantly higher in the male, Black, and 85 + years old populations. The Midwest and rural regions had the highest PE-related mortality rates as well. CONCLUSION: There is an overall increasing trend in PE-related mortality for cancer patients, with a remarkable increase in 2016. This study highlights the specific populations and regions most affected by PE-related mortality emphasizing the need to increase education, timely management, and address disparities for these patients.

Mark Helpful

Bookmark

Relay

View Full Paper