What question did this study set out to answer?

This study aims to assess trends and disparities in mortality for adults with co-listed coronary artery disease and cancer.

May 30, 2026Open Access

Unveiling temporal trends and disparities in mortality with co-listed coronary artery disease and cancer, 1999–2024: insights from the CDC WONDER multiple cause of death database

Key Points

This study aims to assess trends and disparities in mortality for adults with co-listed coronary artery disease and cancer.
Retrospective analysis using CDC WONDER Multiple Cause-of-Death database from 1999 to 2024.
Calculated age adjusted mortality rates (AAMRs) and used Joinpoint Regression Program to evaluate trends.
Total of 1,321,891 deaths with co-listed CAD and cancer recorded over 26 years.
Overall AAMR decreased from 31.38 in 1999 to 19.77 in 2024 (AAPC: -1.88, 95% CI: -2.01 to -1.77).
Significant disparities in AAMR were observed by gender, race, age, urbanization, and region.

Abstract

Abstract Background Coronary artery disease (CAD) remains one of the primary causes of morbidity and mortality worldwide. Although cancer mortality rates have declined in many high-income countries, including the United States, substantial variability persists. This study aimed to assess the trends and disparities in mortality among adults with co-listed CAD and cancer on death certificates. Methods We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause-of-Death database. Data were extracted for co-listed CAD and cancer spanning from 1999 to 2024. Age adjusted mortality rates (AAMRs) were calculated. The Joinpoint Regression Program was used to evaluate annual percentage changes (APC) and average annual percentage change (AAPC) with 95% confidence intervals (CI). Results Over 26 years, 1,321,891 deaths occurred with co-listed CAD and cancer. The overall AAMR decreased from 31.38 in 1999 to 19.77 in 2024 (AAPC: -1.88, 95% CI: -2.01 to -1.77). Men had higher mean AAMRs (36.86) than women (13.93). Among races, the highest mean AAMRs were observed in Non-Hispanic (NH) White (23.84), and NH Black (22.1), followed by NH American Indian or Alaskan Native (15.28), Hispanic (14.00), and NH Asian or Pacific Islander (11.44) individuals. Regionally, the Midwest showed higher mean AAMR (25.21), then Northeast (24.88), South (21.93), and West (21.33). Age group categorization showed highest mean AAMR in older adults (107.05), followed by middle-aged adults (6.35), and younger adults (0.18). Stratified by urbanization, rural areas exhibited higher mean AAMR (27.58) compared to urban areas (22.92). Among states, the highest mortality rates were observed in West Virginia (35.86). Conclusion The AAMR for co-listed CAD and cancer has decreased from 1999 to 2024, with significant disparities persisting in demographics and different regions. These disparities highlight the need for targeted, equitable public health interventions to reduce mortality in these vulnerable populations.

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