S458 Trends and Disparities in Colon Carcinoma With Sepsis-Related Mortality Across the US Adult Population From 1999–2020: A CDC WONDER Analysis

Introduction: Colon carcinoma, one of the leading causes of cancer deaths, is often complicated by sepsis. This study analyzes U.S. mortality trends and disparities in colon carcinoma with sepsis from 1999 to 2020 to guide further interventions of management. Methods: Using CDC WONDER data (1999–2020), we analyzed deaths in adults aged 25+ with International Classification of Diseases, Tenth Revision codes C18 (colon carcinoma) and A41.9 (sepsis). Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, race/ethnicity, region, state, and urban-rural classification. Joinpoint regression calculated annual percent changes (APCs) and average annual percent changes (AAPCs) with 95% confidence intervals [CIs] (P < 0.05). Results: From 1999–2020, 50,354 deaths occurred (AAMR = 1.05/100,000), with a decline from 1999–2012 (APC = -1.80, 95% CI: -2.18, -1.43). Black or African American individuals (AAMR = 1.72) had the highest burden and largest decline (AAPC = -2.02, 95% CI: -2.39, -1.64), followed by White individuals (AAMR = 0.99; AAPC = -1.11, 95% CI: -1.48, -0.74; 1999–2012: APC = -1.71, 95% CI: -2.11, -1.31; 2012–2020: stable). Asian or Pacific Islander (AAMR = 0.84; AAPC = -1.10, 95% CI: -1.85, -0.35) and Hispanic or Latino individuals (AAMR = 1.03; 2005–2020: APC = -0.98, 95% CI: -1.90, -0.06) also declined. Large fringe metro areas (AAMR = 0.99; AAPC = -2.04, 95% CI: -2.45, -1.63) had the sharpest drop, followed by medium (AAMR = 0.95; AAPC = -0.69, 95% CI: -1.06, -0.32) and small metro (AAMR = 1.07; AAPC = -0.82, 95% CI: -1.27, -0.38), while rural noncore areas (AAMR = 1.07; AAPC = 0.21, 95% CI: -0.27, 0.69) rose slightly. Males showed a decline (AAMR = 1.28; AAPC = -1.29, 95% CI: -1.52, -1.06); females (AAMR = 0.87; AAPC = -1.17, 95% CI: -2.49, 0.17) did not. The Northeast (AAMR = 1.12; AAPC = -2.90, 95% CI: -3.15, -2.64) led declines, followed by Midwest (AAMR = 0.95; AAPC = -1.13, 95% CI: -1.49, -0.78) and West (AAMR = 1.03; AAPC = -0.74, 95% CI: -1.14, -0.34). Maryland (AAPC = -3.88), New Jersey (-2.94), New York (-2.92), and Illinois (-1.61) improved; California, Texas, Florida, and Washington stayed stable. Conclusion: Colon carcinoma-sepsis mortality fell from 1999–2020, but disparities remain in race/ethnicity (highest in Black or African American individuals), sex (stable in females), urbanization (rising rural trends), and region/state (stable in California, Texas). Interventions to improve rural and female healthcare access are needed.