# Demographic and regional disparities in cancer cachexia-related mortality in the USA from 1999 to 2020 – A retrospective cross-sectional study

## TL;DR

This study finds that cancer-related cachexia deaths in the USA have declined, but disparities remain based on demographics and geography.

## Contribution

The study identifies demographic and regional disparities in cancer cachexia-related mortality using CDC WONDER data from 1999 to 2020.

## Key findings

- Mortality rates were higher in men, Black adults, and rural populations.
- States in the top 90th percentile had five times higher mortality rates than those in the lower 10th percentile.
- A declining trend in cancer and cachexia-related mortality was observed from 1999 to 2019.

## Abstract

•Based on the CDC WONDER database, an overall declining trend has been identified in cancer and cachexia-related mortality from 1999 to 2019.•Age-adjusted mortality rates were notably higher in men, Black adults and rural populations.•States in the top 90th percentile had approximately five times higher mortality rates than states in the lower 10th percentile.•This study highlights the importance of public health strategies tailored to improve healthcare access and utilisation in population with higher mortality rates.

Based on the CDC WONDER database, an overall declining trend has been identified in cancer and cachexia-related mortality from 1999 to 2019.

Age-adjusted mortality rates were notably higher in men, Black adults and rural populations.

States in the top 90th percentile had approximately five times higher mortality rates than states in the lower 10th percentile.

This study highlights the importance of public health strategies tailored to improve healthcare access and utilisation in population with higher mortality rates.

Nearly 2 million new cancer cases and over half a million cancer deaths in the USA were reported in 2024. Still there remains a paucity of data on cancer-cachexia-related mortality.

The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was utilised to identify cases where both cachexia and cancer were listed as either contributory or underlying causes of death between 1999 and 2020.

Between 1999 and 2020, there were 64,106 deaths related to cancer and cachexia among adults aged ≥55 years. Overall, a declining trend has been identified from 1999 to 2019. Black patients had 1.4 times higher mortality than White patients. Rural dwellers had higher mortality than urban adults. Lastly, states with age-adjusted mortality rates (AAMR) in the 90th percentile (California, South Carolina, Utah, Georgia, Alaska and New Hampshire) displayed approximately five-fold higher AAMR than states in the bottom 10th percentile.

Tailored public health strategies for healthcare access and risk factor management are needed to address these disparities.