National trends and disparities in leukemia and septicemia-related mortality in theunited states from 1999-2023: A CDC wonder database analysis

Abstract Background: Leukemia, a type of cancer of the blood forming tissues, compromises the immune system putting the body at risk of aggressive infections like septicemia. This can not only progress to septic shock but also death. The occurrence of the two conditions makes it almost necessary to understand the epidemiological patterns to increase the rates of survival. This study assesses the trends in mortality in patients with leukemia and septicemia in the United States from 1999-2023. Methods : We analyzed death certificates of adults aged 5 to 84 years' from the CDC-WONDER database with Leukemia (ICD-10 codes: C91, C92) and Septicemia (ICD-10 codes: A40, A41) from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, year and age. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality trends, along with 95% confidence intervals (CIs). Results : Between 1999 and 2023, Leukemia and Septicemia caused 56,497 deaths in patients aged 5 to 84 years. The total AAMR decreased from 0.78 in 1999 to 0.66 in 2023. Demographically, AAMR among the men decreased significantly from 1.04 to 0.85 (AAPC: -0.65; 95% CI: -0.80 to -0.49). Females experienced a decline in mortality from 0.59 to 0.46(AAPC: -0.44; 95% CI: -0.71 to -0.17). In terms of race, a slight decrease in mortality was witnessed in the mortality of Non-Hispanic (NH) Black or African Americans from 0.91 to 0.7 (AAPC:-1.13 ; 95% CI: -1.43 to -0.82), moreover the AAMR in the Hispanics decreased from 0.8 to 0.63 (AAPC: -0.04; 95% CI: -0.04 to -0.58) while those among the white community decreased from 0.78 to 0.68 (AAPC: -0.39; 95% CI: -0.58 to -0.19). Moreover, the Asian community also experienced a declining death rate. Geographically, regions in the Midwest showed the highest overall AAMR (0.75), followed by the West,Northeast and areas in the South with an overall AAMR of 0.72 . Between the urban and rural areas, rural areas had a higher AAMR as compared to the urban areas with an overall AAMR of 0.17. When stratified according to states, AAMRs varied highly from the highest in Kentucky (0.89) to the lowest in Maine(0.26). Conclusion: The overall mortality rates for leukemia and septicemia decreased between the years 1999-2023. The greatest change was seen in males, regions in the Northeast, racially in NH Blacks and the rural areas.