Trends and Disparities in Colorectal and Anal Carcinoma- Related Mortality Among U.S. Adults (1999-2023) with Predictions Using Machine Learning

Objective To examine trends and disparities in colorectal and anal carcinoma-related mortality among United States adults from 1999 to 2023 and to predict future mortality trends. Methods Observational analysis using mortality data from the Centers for Disease Control and Prevention (CDC) WONDER database, covering 1999 to 2023. Trends in age-adjusted mortality rates and crude death rates were assessed using Joinpoint regression models, and projections were made using the Autoregressive Integrated Moving Average (ARIMA) model. United States adults aged 25 years and older, with a total of 1,346,756 deaths related to colorectal and anal carcinoma over the study period. Mortality rates were stratified by demographics (age, sex, race/ethnicity), geographic regions, and urbanization status. Results Age-adjusted mortality rates declined from 32.33 per 100,000 in 1999 to 19.95 in 2020 (average annual percent change = -2.00, p < 0.001). Disparities were observed, with higher rates in males, older adults, non-Hispanic Black individuals, and residents of the South and Midwest. Projections for 2069 suggest continued age-adjusted mortality rate decline but an increase in total deaths due to population aging. Conclusion While overall mortality from colorectal and anal carcinoma has declined, significant disparities persist. Continued monitoring and targeted interventions are necessary to address these disparities and manage future mortality trends.