National mortality trends associated with the death certificate–reported co-occurrence of malignant neoplasms and bacterial diseases in the United States, 1999–2023 - a CDC WONDER retrospective analysis

Q: What is the study’s primary aim?

To analyze national mortality trends in the United States for death-certificate–reported co-occurrence of malignant neoplasms and other bacterial diseases from 1999 to 2023.

Q: How were mortality rates calculated and analyzed?

The study used CDC WONDER retrospective mortality data for individuals aged 15+ to compute age-adjusted mortality rates per 100,000 and annual percent change using joinpoint regression, stratified by multiple demographic and geographic factors.

Q: What were the key findings about mortality trends over time?

From 1999 to 2023, 726,510 co-occurrence deaths were recorded. Age-adjusted mortality declined through about 2012, then rose by 2023, with a positive annual percent change and statistical significance.

Sep 22, 2026

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Cross-sectional retrospective analysis quantifies national mortality trends for death-certificate–reported co-occurrence of malignant neoplasms and bacterial diseases in the United States from 1999 to 2023. Using CDC WONDER mortality data for ages 15+, the study computes age-adjusted mortality rates per 100,000 and annual percent change via joinpoint regression, stratified by year, sex, age, race/ethnicity, urbanization, and region. A total of 726,510 co-occurrence deaths were recorded; mortality later increased, especially among older adults, men, racial minorities, and the West, indicating a rising disease burden needing targeted interventions.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background and objectives

Methods

Results

Conclusion

Keywords

Cross-sectional Study National mortality trends associated with the death certificate–reported co-occurrence of malignant neoplasms and bacterial diseases in the United States, 1999–2023: a CDC WONDER retrospective analysis Palwasha Asghar, MBBSa , Mohammad Sameed Safwan, MBBSb , Abdur Rehman, MBBSb , Sujata Lodh, MBBSc , Mahnoor Sheikh, MBBSd , Kamil Ahmad Kamil, MDe ,* Background and objectives: Growing evidence suggests that bacterial infectious diseases contribute substantially to morbidity and mortality among individuals with malignant neoplasms. However, data regarding mortality related to the co-occurrence of malignant neoplasms and other bacterial diseases is limited. This study analyzes the national mortality trends for the co-occurrence of malignant neoplasms and other bacterial diseases in the United States from 1999 to 2023. Methods: A retrospective study was conducted using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research mortality data for individuals aged 15+ to calculate age-adjusted mortality rates (AAMRs) per 100 000 and annual percent change (APC) using joinpoint regression, stratified by year, sex, age, race/ethnicity, urbanization, and geographic regions. Results: From 1999 to 2023, 726 510 deaths were recorded involving malignant neoplasms co-occurring with bacterial diseases. The AAMR slightly declined from 8.14 in 1999 to 7.63 in 2012, followed by a rise to 10.02 in 2023 with an APC of 2.51 (95% confidence interval: 2 .14–2.89, P < 0.05) . Males had higher mortality rates than females, declining until 2012, then increasing, while female rates were stable before rising after 2013. West exhibited the greatest increase in AAMR. Non-Hispanic Black individuals had the highest absolute AAMRs throughout the study period. Nonmetropolitan areas showed greater increases in AAMRs compared to metropolitan areas. Older age groups, especially those 65 years and above, predominantly contributed to mortality. Conclusion: Despite improvements, mortality from bacterial diseases and malignant neoplasms has increased, particularly affecting older adults, men, racial minorities, and the western region, requiring targeted interventions to reduce disease burden invulnerable communities. Keywords: age-adjusted mortality rate, bacterial diseases, CDC WONDER, epidemiology, malignant neoplasms, mortality trends, multiple cause of death, United States aDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan, bDepartment of Medicine, King Edward Medical University, Lahore, Pakistan, cDepartment of Medicine, Dr. KNS Memorial Institute of Medical Sciences, Barabanki, Uttar Pradesh, India, dDepartment of Medicine, Pak International Medical College, Peshawar, Pakistan and eInternal Medicine Department, Mirwais Regional Hospital, Kandahar, Afghanistan Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: Internal Medicine Department, Mirwais Regional Hospital, Shahre-Naw, Mirwais Regional Hospital, Kandahar 3801, Afghanistan. Tel.: +93 [704736171. E-mail: drkamilahmad1@gmail.com](704736171. E-mail: drkamilahmad1@gmail.com) (K. A. Kamil). Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Annals of Medicine & Surgery (2026) 88:3105–3111 Received 12 January 2026; Accepted 25 March 2026 Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website, [www.lww.com/annals-of-medicine-and-surgery](www.lww.com/annals-of-medicine-and-surgery). Published online 8 May 2026 [http://dx.doi.org/10.1097/MS9.0000000000005031](http://dx.do

FAQs

What is the study’s primary aim?

To analyze national mortality trends in the United States for death-certificate–reported co-occurrence of malignant neoplasms and other bacterial diseases from 1999 to 2023.

How were mortality rates calculated and analyzed?

The study used CDC WONDER retrospective mortality data for individuals aged 15+ to compute age-adjusted mortality rates per 100,000 and annual percent change using joinpoint regression, stratified by multiple demographic and geographic factors.

What were the key findings about mortality trends over time?

From 1999 to 2023, 726,510 co-occurrence deaths were recorded. Age-adjusted mortality declined through about 2012, then rose by 2023, with a positive annual percent change and statistical significance.

Sep 22, 2026

Upload by supergirl