Prostate cancer and diabetes: A retrospective analysis of mortality trends in the United States (1999–2024)

Diabetes mellitus is a prevalent comorbid condition that can influence the progression of prostate cancer, which remains one of the leading malignancies among men in the United States. Knowing the long-term mortality trends in this high-risk population is essential for developing care, early diagnosis, and prevention plans. Using surveillance data from the Centers for Disease Control and Prevention, we evaluated how prostate cancer mortality among diabetic United States adults has changed over the 25 years between 1999 and 2024. International Classification of Diseases, 10th Revision codes for prostate cancer (C61) and diabetes (E10–E14) were utilized to examine mortality trends. Deaths were counted when prostate cancer was listed as the underlying cause and diabetes was listed as a contributing cause of death. We analyzed race, urban/rural, state, and census region-wise mortality trends. Joinpoint (V5.4.0) was used to analyze trends. Across 1999 to 2024, male age-adjusted mortality rates showed a fluctuating but overall stable pattern, with an initial significant decline, a marked rise after 2017, and a subsequent nonsignificant decrease, resulting in no significant long-term trend (average annual percent change = −0.41). Racial disparities were consistent, with non-Hispanic (NH) Black individuals experiencing the highest mortality rates, followed by NH Whites and Hispanics, while other groups remained stable. Urban and rural trends showed parallel temporal fluctuations, with higher rates in rural areas but no sustained long-term differences. Considerable heterogeneity was observed across states and census regions, with the West showing a significant upward trend overall. These findings warrant better, more targeted interventions that should prevent and control the deaths of prostate cancer in diabetic adults with a focus on the NH Black or African American populations and areas that are experiencing more deaths.