National mortality trends associated with the death certificate–reported co-occurrence of malignant neoplasms and bacterial diseases in the United States, 1999–2023: a CDC WONDER retrospective analysis

Background and objectives: Growing evidence suggests that bacterial infectious diseases contribute substantially to morbidity and mortality among individuals with malignant neoplasms. However, data regarding mortality related to the co-occurrence of malignant neoplasms and other bacterial diseases is limited. This study analyzes the national mortality trends for the co-occurrence of malignant neoplasms and other bacterial diseases in the United States from 1999 to 2023. Methods: A retrospective study was conducted using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research mortality data for individuals aged 15+ to calculate age-adjusted mortality rates (AAMRs) per 100 000 and annual percent change (APC) using joinpoint regression, stratified by year, sex, age, race/ethnicity, urbanization, and geographic regions. Results: From 1999 to 2023, 726 510 deaths were recorded involving malignant neoplasms co-occurring with bacterial diseases. The AAMR slightly declined from 8.14 in 1999 to 7.63 in 2012, followed by a rise to 10.02 in 2023 with an APC of 2.51 (95% confidence interval: 2.14–2.89, P < 0.05). Males had higher mortality rates than females, declining until 2012, then increasing, while female rates were stable before rising after 2013. West exhibited the greatest increase in AAMR. Non-Hispanic Black individuals had the highest absolute AAMRs throughout the study period. Nonmetropolitan areas showed greater increases in AAMRs compared to metropolitan areas. Older age groups, especially those 65 years and above, predominantly contributed to mortality. Conclusion: Despite improvements, mortality from bacterial diseases and malignant neoplasms has increased, particularly affecting older adults, men, racial minorities, and the western region, requiring targeted interventions to reduce disease burden in vulnerable communities.