P3819 - Disparities in Mortality Trends Among Rural Residents With Metastatic Gastrointestinal Cancers in the United States: A CDC WONDER Database Analysis

Umar Hayat, MD¹, M Danial Ali Shah, MD², Muhammad Kamal, MD³, Umer Farooq, DM⁴, Manesh Kumar Gangwani, MD⁵, Hassam Ali, MD⁶, Dushyant S. Dahiya, MD⁷, Amna Iqbal, MD⁸, Waqas Rasheed, MD⁹, Usman I. Rana, MD¹⁰, Faisal Kamal, MD¹¹, Kishore Kumar, MD^12
1Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; ²King Edward Medical University, Lahore, Punjab, Pakistan; ³Hackensack Meridian Health, Roselle Park, NJ; ⁴Saint Luke's University Hospital, St. Louis, MO; ⁵University of Toledo, Toledo, OH; ⁶ECU Health Medical Center, Greenville, NC; ⁷The University of Kansas School of Medicine, Kansas City, KS; ⁸University of Toledo Medical Center, Toledo, OH; ⁹University of Kentucky, Lexington, KY; ¹⁰The Wright Center for Graduate Medical Education, Scranton, PA; ¹¹Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; ¹²Geisinger Community Medical Center, Scranton, PA

Introduction: Gastrointestinal (GI) cancers pose a significant public health challenge due to their high morbidity and mortality rates. Rural residents often face worse prognoses and limited access to healthcare. This study aims to uncover the disparities affecting rural populations in the United States (US) to inform policymaking and guide resource allocation, reduce health inequities, and enhance the overall quality of care for patients nationwide.

Methods: A retrospective analysis was conducted using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Data were extracted using ICD-10 codes to identify deaths due to metastatic GI cancers among the rural population in the US aged ≥35 years from 1999 to 2020. Mortality rates were analyzed based on age, gender, race, geographic region, and place of death. Results were reported as age-adjusted mortality rates (AAMR) with 95% confidence intervals (CI). Trends over time were identified using joinpoint regression and reported as the average annual percentage change (AAPC).

Results: From 1999 to 2020, a total of 617,635 deaths were reported due to metastatic GI cancers, with an AAMR of 93.3 per 100,000 (95% CI: 93.1-93.6, p< 0.05). The AAMR decreased from 101.1 in 1999 to 91.4 in 2020 (AAPC -0.48; 95% CI -0.52 to -0.43, p< 0.05). Males had a higher AAMR than females (120.2 vs. 70.9), and non-Hispanics had a higher AAMR than Hispanics (93.5 vs. 84.0) Figure 1A & B. Among racial groups, the Black population had the highest AAMR (124.0), while Asians had the lowest (79.2). The South region was the most affected, with an AAMR of 96.8. State variations showed the highest AAMRs in Louisiana and Alaska (107.4 and 107.3) and the lowest in Colorado and Utah (74.2 and 68.2). Union County, Florida, had the highest AAMR of 250.5, whereas Pitkin County, Colorado, had the lowest at 33.1. Most deaths were reported in the deceased's homes (44.5%), followed by nursing homes (16.6%) and hospice facilities (4.4%). Most deaths were in the 75-84 age group (27.9%).

Discussion: Despite the significant overall decline in metastatic GI cancer-related mortality, significant disparities persist. These findings underscore the need for targeted interventions to address these inequalities in susceptible demographics.



Disclosures:


Umar Hayat, MD¹, M Danial Ali Shah, MD², Muhammad Kamal, MD³, Umer Farooq, DM⁴, Manesh Kumar Gangwani, MD⁵, Hassam Ali, MD⁶, Dushyant S. Dahiya, MD⁷, Amna Iqbal, MD⁸, Waqas Rasheed, MD⁹, Usman I. Rana, MD¹⁰, Faisal Kamal, MD¹¹, Kishore Kumar, MD¹². P3819 - Disparities in Mortality Trends Among Rural Residents With Metastatic Gastrointestinal Cancers in the United States: A CDC WONDER Database Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.