Temporal trends and disparities in sudden cardiac death among colorectal cancer patients: A nationwide study
Eric Sanji1, Juste Niba2, Terence Longla3, Lathifa Nnap4, Charmain Mbaki5 and Bonaventure Dzekem6
1 Magnolia Regional Health Center, Corinth, MS 38834, USA
2 Swiss Care Hospital, Limbe, Cameroon
3 Woodhull Medical Center, Brooklyn, NY 11206, USA
4 Faculty of Health Sciences, University of Buea, Southwest Region, Cameroon
5 Cygnet Wast Hills Hospital, Birmingham, United Kingdom
6 Department of Medicine, University of Chicago, Chicago, IL 60637, USA
Correspondence to:
Eric Sanji, email: [email protected], [email protected]
Keywords: racial disparities; sudden cardiac death; colorectal cancer; cancer mortality; cardio-oncology
Received: June 23, 2025 Accepted: November 02, 2025 Published: November 07, 2025
ABSTRACT
Background: Colorectal cancer (CRC) patients are at risk of cardiovascular problems, especially sudden cardiac death, due to aging, pre-existing comorbidities, and cardiotoxic medicines. Few large-scale epidemiologic studies on SCD trends and disparities in CRC patients exist. The goal is to examine US CRC decedent SCD trends and sociodemographic variations from 1999 to 2020.
Methods: A retrospective population-based analysis was conducted using the CDC WONDER Multiple Cause of Death database (1999–2020). Colorectal cancer (CRC) fatalities were identified using ICD-10 codes C18–C21, and sudden cardiac death (SCD) was defined using ICD-10 codes I46.1, I46.9, R96.0, I49.0, and I21–I24. Age-adjusted and crude death rates were estimated by sex, race/ethnicity, age group, and U.S. state. Temporal trends were assessed using linear regression. Subgroup analyses were also performed by age, sex, and geographic region.
Results: The age-adjusted mortality rate of SCD among CRC decedents reduced from 1.2 to 0.5 per 100,000 population between 1999 and 2020, demonstrating a steady trend. Males had greater SCD rates than females for two decades. Age-stratified analysis showed that CRC patients aged 65–84 carried the most SCD burden. Race and ethnicity affected SCD mortality, with Black and Asian/Pacific Islanders dying more than Whites. Geographic study found high SCD rates in Nebraska and Vermont and low rates in California and Texas.
Conclusions: Despite age-adjusted rate decreases over two decades, SCD remains a significant contributor to death in CRC patients. Persistent discrepancies by gender, race, and geography underline the importance of individualized cardio-oncology surveillance, equitable preventative initiatives, and focused public health interventions.
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