A comprehensive five-year analysis of gastric cancer mortality disparities in the midwest region (2018–2023): Trends, factors, and implication.

Abstract

e16154 Background: Gastric cancer is a major public health issue, contributing to morbidity and mortality. In the U.S., disparities in gastric cancer mortality exist based on age, gender, race, ethnicity, and socioeconomic status. Despite a decline in overall mortality, some groups still face elevated risks. This study explores gastric cancer mortality trends in the Midwest (2018–2023). Methods: This retrospective study analyzed adults aged 25+ using CDC WONDER (2018–2023) and ICD-10 code C16. Mortality data were stratified by age, gender, race, and Hispanic status. Crude and age-adjusted mortality rates (AAMRs) per 100,000 were calculated, with 95% confidence intervals (CIs). Temporal trends and annual percentage changes (APCs) were assessed using Joinpoint regression. Results: A total of 12,047 deaths occurred in the Midwest, with an AAMR of 2.31 (APC -1.77, CI -2.78 to -0.76, p < 0.001) and a crude rate of 2.93 (CI: 2.88-2.98). Mortality increased with age, peaking at 85+ years (AAMR 21.48; crude 21.49), followed by 75–84 (AAMR 14.71; crude 14.75), 65-74 (7.77), 55-64 (4.34), 45-54 (2.05), 35-44 (0.77), and 25-34 (0.19). Males had a higher AAMR (3.13; APC -2.33, CI -4.43 to -0.30, p = 0.025) than females (1.66), with CR of 3.63 (CI: 3.55-3.71) vs. 2.24 (CI: 2.17-2.30). Black individuals had the highest crude (4.20, CI: 4.01-4.39) and AAMR (4.52), followed by Asians (3.17, CI: 2.88-3.46; AAMR 3.98) and Whites (2.83, CI: 2.77-2.88; AAMR 2.08). AI/AN crude was 1.91 (CI: 1.49-2.42), and multiracial, 0.65 (CI: 0.50-0.82). Hispanics had a higher AAMR (4.13; APC -4.71, CI -8.11 to -1.18, p = 0.009) than non-Hispanics (2.24; APC -1.66, CI -3.20 to -0.11, p = 0.039), although their CR (2.43, CI: 2.26-2.59) was lower than non-Hispanics (2.97, CI: 2.92-3.03). Conclusions: Mortality rates were highest among older adults, males, Black individuals, and Hispanics, reflecting ongoing disparities. Structural inequities, including socioeconomic barriers and limited healthcare access, significantly influence these trends. Addressing these requires better preventive care, addressing social determinants, and implementing culturally competent interventions. These findings highlight the need for equitable healthcare policies to reduce mortality and improve outcomes. Group AAMR (per 100,000) APC 95% CI p-value Overall 2.31 -1.77 -2.78 to -0.76 <0.001 Age  75–84 years 14.71 -2.37 -4.49 to -0.26 0.02  85+ years 21.48 -1.24 -5.10 to 2.49 0.49 Gender  Males 3.13 -2.33 -4.43 to -0.30 0.02  Females 1.66 -1.30 -2.79 to 0.21 0.09 Race  Black 4.52 -3.27 -7.41 to 0.73 0.11  Asian 3.98 -4.35 -19.65 to 14.97 0.53  White 2.08 -1.47 -4.51 to 1.60 0.29 Hispanic Status  Hispanic 4.13 -4.71 -8.11 to -1.18 0.009  Non-Hispanic 2.24 -1.66 -3.20 to -0.11 0.03