A silent but rising threat: Increasing small intestinal cancer mortality among older adults in the United States.

Abstract

e16482 Background: Small intestinal cancer is a rare but increasingly diagnosed malignancy that presents unique management challenges in the geriatric population due to age-related physiological changes. This study evaluates small intestine mortality trends among the older population in the United States from 1999 to 2023, stratified by demographic and geographic factors. Methods: The mortality data from the CDC WONDER multiple cause of death files for adults aged ≥65 years were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 100,000 through ICD-10 Codes: C17, stratified by year, gender, race/ethnicity, and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: From 1999 to 2023, a total of 42,200 deaths were reported among older adults with small intestinal cancer, with most occurring at Decedent's home. The overall AAMR increased from 7.43 in 1999 to 9.28 in 2023 (AAPC: 1.41; 95% CI: 1.06 to 1.75; p < 0.001), with the most significant increase between 2011 and 2023 (APC: 3.18; 95% CI: 2.72 to 3.65). Adults aged 85 years and older exhibited the highest CMR with an annual increase of 2.22% (p < 0.001). Women consistently showed higher annual increases in mortality compared with men (1.47 vs. 1.19). The highest AAMRs were observed among NH Blacks, while the lowest were noted among Hispanics or Latinos. Geographic disparities were evident, with the South experiencing the greatest rise and the Northeast the least. Metropolitan areas showed a steeper increase than non-metropolitan areas (AAPC: 1.39 vs. 0.82). Mississippi and Oklahoma ranked highest, falling within the top 90th percentile. Conclusions: Mortality from small cancer among older adults has increased over the past two decades in the U.S., with disproportionate burden in women, NH Blacks, the population of metropolitan areas, and Southern regions and some central states, underscoring the need for targeted interventions and equitable healthcare access while addressing geographic and age-related inequities. Average Annual Percentage Changes (AAPC) per 100,000 for trends related to small intestinal cancer mortality among older adults from 1999 to 2023. Variable AAPC (95%CI) P-Value Overall 1.41(1.06 to 1.75) 0.000001 Male 1.19(0.76 t 1.62) 0.000001 Female 1.47(0.82 to 2.12) 0.000001 NH Blacks 1.86 (1.26 to 2.47) 0.000001 Hispanic or Latinos 1.18 -0.46 to 2.84) 0.159478 South 1.59 (0.98 to 2.20) 0.000001 Northeast 0.23 (-1.33 to 1.82) 0.772880 Non-metropolitan areas 0.82 (-0.17 to 1.84) 0.104715 Metropolitan areas 1.39 (0.94 to 1.84) < 0.000001