Persistent Disparities in the Face of Decline: A Two-Decade Population-Based Study of Cancer Deaths Involving Renal Failure in the United States

Background: Cancer and renal failure often occur together in clinical practice, but national patterns of cancer deaths that also involve renal failure have not been well described. Objectives: To assess long term trends in cancer deaths that list renal failure as a contributing cause among U.S. adults aged 45 years and older from 1999 to 2020, and to identify key demographic and geographic differences. Methods: We used CDC WONDER multiple cause of death data. Cancer deaths (ICD 10 C00 to C97) that also listed renal failure anywhere on the death certificate were included. Age adjusted mortality rates were calculated, and trends were evaluated across age, sex, race, region, and urban rural status. Results: From 1999 to 2020, 483,738 cancer deaths involved renal failure. The national age adjusted mortality rate declined slightly over time. Higher rates were consistently seen in men, Black individuals, older adults, non-metropolitan areas, and residents of the West and Midwest. Genitourinary and hematologic cancers showed the highest mortality levels. Conclusion: Cancer deaths involving renal failure have decreased modestly but show clear and persistent disparities. These findings highlight the need to address gaps in cancer and kidney care, especially in high burden demographic and geographic groups.