Obesity-related cancer mortality in the US (1999–2020): A CDC WONDER analysis.

e23052 Background: Obesity is a major public health issue and a key risk factor for various cancers. This study examines U.S. mortality trends (1999–2020), focusing on demographic, geographic, and urbanization disparities. Methods: CDC WONDER mortality data (ages 25+) from 1999–2020 were analyzed. Age-adjusted mortality rates (AAMRs) per million were calculated by gender, race/ethnicity, age, urbanization, and region. Joinpoint regression assessed trends, yielding average annual percentage change (AAPC) with 95% confidence intervals (CIs) and p-values. Results: Obesity-related cancers caused 33,572 deaths. AAMRs rose from 3.73/million (95% CI 3.45–4.01) in 1999 to 13.52/million (95% CI 13.08–13.97) in 2020 (AAPC: 5.92%; 95% CI 5.23–6.44; p &lt; 0.000001). Females had higher AAMRs (7.22/million; 95% CI 7.12–7.32) than males (6.59/million; 95% CI 6.48–6.70). AAPC was 5.37% for females (95% CI 4.58–5.98; p &lt; 0.000001) and 6.75% for males (95% CI 6.23–7.24; p &lt; 0.000001). Blacks had the highest AAMRs (9.2/million; 95% CI 8.92–9.47), followed by American Indians (9.04/million; 95% CI 7.90–10.18) and Whites (7.13/million; 95% CI 7.04–7.22). Hispanics showed the steepest AAPC (6.31%; 95% CI 3.78–9.29; p &lt; 0.000001). Mortality was highest in adults 65+ (AAMR: 20.82/million; 95% CI 20.52–21.11) with an AAPC of 6.26% (95% CI 5.39–6.90; p &lt; 0.000001). The Midwest had the highest AAMR (7.96/million; 95% CI 7.79–8.13), while the Northeast had the lowest (5.7/million; 95% CI 5.54–5.85). Rural areas had higher AAMRs (9.45/million; 95% CI 9.24–9.66) than urban areas (6.4/million; 95% CI 6.32–6.48), with rural rates rising more sharply (AAPC: 6.98%; 95% CI 5.97–8.75; p &lt; 0.000001). Most deaths occurred in inpatient medical facilities (13,373), followed by homes (10,251). Conclusions: Obesity-related cancer mortality has risen sharply (1999–2020), with disparities by gender, race, geography, and urbanization. Targeted public health efforts are needed for high-risk groups, particularly older adults, rural residents, and minorities, to curb mortality rates. Cohort Age Adjusted Mortality Rate Average Annual Percentage Change 95% Confidence Intervel P-Value 1999-2020 Overall 6.91 5.9154* 5.2327-6.4383 &lt; 0.000001 Female 7.22 5.3651* 4.5786-5.9763 &lt; 0.000001 Male 6.59 6.7506* 6.2337-7.2375 &lt; 0.000001 African American 9.2 5.3656* 4.7002-6.0455 &lt; 0.000001 White 7.13 6.1847* 5.5699-6.6384 &lt; 0.000001 Hispanic 7.13 6.3087* 3.784-9.2911 &lt; 0.000001 Northeast 5.7 5.5577* 4.2074-6.4733 &lt; 0.000001 Midwest 7.96 6.0083* 5.2882-6.6144 &lt; 0.000001 South 6.45 6.5877* 5.8531-7.2197 &lt; 0.000001 West 7.7 5.4055* 4.7-6.4746 &lt; 0.000001 Less than 65 3.54 5.4362* 4.7101-5.9887 &lt; 0.000001 above 65 20.82 6.2611* 5.3948-6.9027 &lt; 0.000001 Urban 6.4 6.0294* 5.3265-6.6022 &lt; 0.000001 Rural 9.45 6.9779* 5.9664-8.7491 &lt; 0.000001 </jats