Trends in pulmonary embolism mortality in cancer patients in the United States from 1999-2022– A CDC Wonder database study
Elizabeth J. Dort, Hannah Rud, Taylor Billion, Abubakar Tauseef
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.