University of Toledo College of Medicine and Life Sciences, Toledo, OH
Sree Jambunathan , Jacob Lang , Malik Mays , Mersiha Hadziahmetovic , Oluchi Ukaegbu Oke , Obi Ekwenna
Background: The COVID-19 pandemic has caused unprecedented disruptions in medical care, especially in those with cancer. Prior studies have demonstrated a higher risk of mortality in patients with cancer and COVID-19, which could be due to factors such as immunosuppression and higher burden of co-morbidities. However, there are limited studies examining the impact of sociodemographic factors including race, gender, rurality, and region on mortality in patients with COVID-19 and cancer. This study aims to characterize and analyze sociodemographic trends in COVID-19 mortality in patients with cancer. Methods: Data on patients with COVID-19 and cancer listed on death certificates from the Multiple Cause of Death Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database were extracted. Age-adjusted mortality rates (AAMR) were calculated and compared across sociodemographic groups. Results: A total of 18,467 total deaths occurred in patients with COVID-19 and cancer listed on multiple cause of death certificates in 2020, with overall AAMR of 4.4 (95% CI: 4.4-4.5). AAMR for patients with COVID-19 and cancer was significantly higher in Non-Hispanic (NH) Black or African American (7, 95% CI: 6.8-7.3), NH American Indian or Alaska Native (6.4, 95% CI: 5.4-7.3), and Hispanic or Latino (5.4, 95% CI: 5.2-5.7) groups than NH White (4, 95% CI: 3.9-4.1) and NH Asian or Pacific Islander (2.5, 95% CI: 2.3-2.7). AAMR was also higher in males (5.9, 95% CI: 5.8-6.1) and those in Northeast (5.6, 95% CI: 5.4-5.8) and Midwest (5.3, 95% CI: 5.2-5.5) census regions. Those in medium metro counties had significantly lower AAMR (3.8, 95% CI: 3.7-4) compared to other locations based on the NCHS Urban-Rural Classification Scheme for Counties. Conclusions: AAMR in patients with any cancer and COVID-19 was significantly higher in NH Black or African American, NH American Indian or Alaskan, and Hispanic or Latino race/ethnicity groups, as well as in males. Regional and rurality disparities also exist. This study highlights persistent disparities in COVID-19 and cancer outcomes and identifies groups at higher risk of mortality. Future studies examining sociodemographic trends in COVID-19 mortality in patients with specific cancers are necessary.
Race | Age Adjusted Mortality Rate (95% CI) |
---|---|
NH Asian or Pacific Islander | 2.5 (2.3-2.7) |
NH White | 4 (3.9-4.1) |
Hispanic or Latino | 5.4 (5.2-5.7) |
NH American Indian or Alaska Native | 6.4 (5.4-7.3) |
NH Black or African American | 7 (6.8-7.3) |
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