# Temporal trends and disparities in sudden cardiac death among colorectal cancer patients: A nationwide study

## TL;DR

This study finds that sudden cardiac death rates among colorectal cancer patients in the U.S. have decreased over time but still vary by gender, race, and geography.

## Contribution

The paper provides a nationwide analysis of sudden cardiac death trends and disparities among colorectal cancer patients from 1999 to 2020.

## Key findings

- Age-adjusted sudden cardiac death rates among CRC patients decreased from 1.2 to 0.5 per 100,000 between 1999 and 2020.
- Males consistently had higher SCD rates than females, and CRC patients aged 65–84 had the highest SCD burden.
- Black and Asian/Pacific Islander CRC patients had higher SCD mortality rates compared to White patients.

## Abstract

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.