ArticleFrontiers in oncology2026
Regional, demographic, and temporal trends in psychoactive substance use-related mental disorder and cancer mortality in U.S. adults: a nationwide CDC WONDER analysis (1999-2020).
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cancer remains a major global health burden, with 10 million deaths in 2020 and among the 35 million adults worldwide with psychoactive substance use disorders (SUDs), it is a major contributor to premature mortality. In the U.S., tobacco causes over 30% of cancer deaths and alcohol nearly 5%, highlighting the role of modifiable behaviors. Despite this clinical and economic burden, national long-term data on co-occurring SUDs and cancer mortality remain limited. We therefore analyzed 22 years (1999-2020) of U.S. mortality data from CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) to evaluate temporal trends and demographic and geographic disparities in psychoactive substance-related mental disorder mortality in relation to cancer among adults aged ≥25 years. Methods: Mortality data for adults aged ≥25 were obtained from CDC WONDER using ICD-10 codes C00-D48 (cancer) and F10-F19 (psychoactive substance-related mental disorders). We calculated age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) by demographics and region. Subgroup analyses paired cancer deaths with alcohol, tobacco, and other psychoactive substance categories to assess substance-specific trends. Results: From 1999-2020, 1,789,591 deaths involved both cancer and substance use (SU)-related mental disorders. Overall AAMR rose from 5.66 in 1999 to 43.26 in 2020, increasing sharply from 1999-2005 (APC: 41.67), more gradually through 2012 (APC: 4.36), and stabilizing thereafter (APC: -1.23; p>0.05). Rates were higher in males than females (51.57 Conclusion: Overall, AAMR plateaued after 2012, with the highest burden in NH American Indian/Alaska Natives, males, and rural Midwest residents, highlighting demographic and geographic disparities among individuals with concomitant cancer and psychoactive substance use-related mental disorders.
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