Mortality Trends and Disparities for the Six Leading Causes of Cancer Death Among Individuals Aged 15–45 Years in the United States, 1999–2023 - 04/07/26
, Yangjie Liu 2, #
, Xia Chen 3
, Tian Lv 4
, Anwei Wu 5, ⁎ 
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Highlights |
• | In our study, from 1999 to 2023, colorectal cancer (CRC) mortality among U.S. individuals aged 15–45 years increased significantly by 24.8% (AAPC: 0.88*, 95% CI: 0.72–1.04), making CRC the only major cancer with a sustained upward trajectory in this age group. |
• | Marked disparities persist across census regions, racial/ethnic groups, and sex. Notably, non-Hispanic Black or African American individuals experienced the highest CRC mortality rate (2.15 per 100,000 in 2023), while Hispanic or Latino individuals showed the most rapid increase (AAPC: 1.79*). |
• | ARIMA projections through 2035 indicate that CRC mortality among individuals aged 15–45 years will continue to rise, whereas mortality from lung cancer, breast cancer, and leukemia is expected to keep declining. |
• | The rising CRC mortality in this age group signals an urgent public health challenge. Risk-stratified screening strategies, equitable access to care, and targeted interventions for high-risk populations are critically needed. |
Abstract |
Background |
Cancer mortality among individuals aged 15–45 years is a critical metric for assessing progress in cancer control. This study examined long-term mortality trends and sociodemographic disparities for the six leading causes of cancer death among individuals aged 15–45 years in the United States from 1999 to 2023.
Methods |
Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999–2023). Death records for individuals aged 15–45, with any of the six cancers listed as the underlying cause, were included. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Temporal trends were analyzed using Joinpoint regression to compute the average annual percent change (AAPC) and 95% confidence interval (CI). Future mortality through 2035 was projected using autoregressive integrated moving average (ARIMA) modeling.
Results |
Between 1999 and 2023, Lung cancer mortality declined most sharply (AAPC: –4.79*; 95% CI: –5.45 to –4.13). Breast cancer mortality also exhibited a significant decrease. In contrast, colorectal cancer (CRC) mortality increased significantly (AAPC: 0.88*; 95% CI: 0.72 to 1.04), emerging as the only major cancer with a sustained upward trajectory in this age group. Mortality from leukemia, brain cancer, and cervical cancer remained stable or declined modestly. Pronounced disparities were observed across census regions, racial/ethnic groups, and sex. ARIMA projections indicated that CRC mortality among individuals aged 15–45 years is expected to increase further through 2035, whereas mortality from lung cancer and breast cancer is projected to continue declining.
Conclusion |
Substantial reductions in lung cancer mortality among individuals aged 15–45 years in the United States have been offset by a concerning rise in colorectal cancer mortality in this age group. Strategic shifts toward risk-stratified screening, equitable care, and targeted interventions are imperative.
Le texte complet de cet article est disponible en PDF.Keywords : CDC WONDER, United States, colorectal cancer, cancer, mortality rate
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