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Thank you for attending THSNA 2026. The virtual meeting is now closed.
Thank you for attending THSNA 2026. The virtual meeting is now closed.
Presentation Details
| Trends in Age-Adjusted Mortality Rates for Disseminated Intravascular Coagulation in Solid and Hematologic Cancer Patients: A 22-Year Analysis of United States Mortality Data by Sex, Race, and Geographic Region, 1999-2020. Jiss Joy1, Rahul Anand1, Joan D.Beckman2. 1Department of Internal Medicine, The Guthrie Clinic, Robert Packer Hospital, Sayre, PA, USA.2Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, USA |
Abstract
Background Disseminated intravascular coagulation (DIC) represents a critical complication in cancer patients with significant mortality implications. Despite its clinical importance, comprehensive epidemiological data examining long-term mortality trends and demographic disparities in DIC among cancer patients remain limited. Understanding these trends is essential for assessing therapeutic advances and identifying vulnerable populations requiring targeted interventions. Objectives To analyze temporal trends in age-adjusted mortality rates for DIC in patients with solid and hematologic malignancies across 22 years, stratified by sex, race/ethnicity, and geographic region. Methods We analyzed mortality data from the CDC WONDER database (1999-2020) using ICD-10 codes D65 for DIC and C00-C97 for malignant neoplasms. The study included individuals aged 25-85+ years. Age-adjusted mortality rates per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression analysis identified significant trend changes and calculated annual percent changes (APC) for overall trends and subgroups by sex, race/ethnicity (Asian or Pacific Islander, Black or African American, White, Hispanic or Latino), and U.S. Census regions. American Indian/Alaska Native populations were excluded due to unreliable estimates. Results Among 17,499 DIC-related deaths identified, overall age-adjusted mortality declined 41%, from 0.56 per 100,000 (1999) to 0.33 per 100,000 (2020). Males demonstrated consistently higher mortality than females (0.67 vs 0.44 per 100,000 in 1999; 0.36 vs 0.30 per 100,000 in 2020). Males experienced steep decline from 1999-2006 (APC -5.21%) followed by slower decline through 2020 (APC -1.44%). Females showed declining trends from 1999-2014 (APC -2.76%) but increased from 2014-2020 (APC 1.61%). Significant racial disparities emerged. Asian or Pacific Islander patients exhibited dramatic initial decline (APC -19.11%, 1999-2002) with subsequent variable trends. Black or African American patients demonstrated initial decline (APC -6.41%, 1999-2008) that plateaued thereafter (APC 0.36%, 2008-2020). White and Hispanic or Latino patients showed consistent declines throughout (APC -1.73% and -0.99%, respectively, 1999-2020) without joinpoints. All U.S. Census regions demonstrated declining trends: Northeast (APC -15.00%, 1999-2002; APC -1.50%, 2002-2020), Midwest (APC -6.09%, 1999-2005; APC -2.18%, 2005-2020), South (APC -1.40%, 1999-2020), and West (APC -0.99%, 1999-2020). Conclusions Age-adjusted mortality rates for DIC in cancer patients declined significantly over 22 years, likely reflecting improvements in supportive care, early recognition, and DIC management. However, persistent racial and gender disparities exist, particularly the plateauing of mortality among Black patients after 2008 and the uptick in female mortality after 2014. These findings underscore the need for targeted quality improvement initiatives and equitable access to treatment to address ongoing disparities in DIC outcomes among vulnerable cancer populations.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.