Cardiovascular disease and gastrointestinal cancers: Mortality trends and persistent disparities in the U.S.

Abstract

e15684 Background: Cardiovascular disease (CVD) is a significant contributor to mortality among patients with gastrointestinal tract (GIT) cancers. This study analyses changes in age-adjusted mortality rates (AAMRs) for CVD in GIT cancer patients in the U.S. from 1999 to 2020, focusing on demographic and geographic disparities. Methods: CVD-related deaths in GIT cancer patients aged ≥25 years were examined using CDC WONDER data. AAMRs per 100,000 individuals were calculated, and trends were assessed via annual percentage changes (APCs) and average annual percentage changes (AAPCs). Results: Between 1999 and 2020, 921,107 CVD deaths occurred among GIT cancer patients. The overall AAMR decreased from 230.0 in 1999 to 190.7 in 2020, with an AAPC of -0.97* (p < 0.000001). Men had higher AAMRs (255.3) than women (144.4), though women experienced a greater decline (AAPC: -1.44*, p < 0.000001) compared to men (AAPC: -0.88*, p < 0.000001). Black individuals exhibited the highest AAMR (273.03), followed by Hispanics (199.3), Asians/Pacific Islanders (190.0), American Indians (182.75), and Whites (180.87). Asians/Pacific Islanders showed the steepest decline (AAPC: -2.56*, p < 0.000001). Geographically, New York had the highest AAMR (318.73), while Utah recorded the lowest (98.05). Nonmetropolitan areas showed higher AAMRs than metropolitan areas but smaller declines (AAPC: -0.15*, p = 0.003 vs. -1.13*, p < 0.000001). Conclusions: Despite overall declines in CVD mortality among GIT cancer patients, significant disparities persist by gender, race, and geography. Targeted interventions are needed to address these inequalities and further reduce the burden of CVD among this vulnerable population. Variables Deaths AAMR Race  American Indian/Alaska Native 4,666 3.99  Black or African American 119,234 6.15  Asian or Pacific Islander 34,267 4.49  Hispanic or Latino 77,043 4.68 Sex  Female 403,065 3.22  Male 548,983 5.95 Urbanization  Metropolitan 754,393 4.26  Non-metropolitan 166,714 4.36 Place of Death  Decedent’s Home 633,438 N/A  Medical Facility - Dead on Arrival 5,416 N/A  Hospice Facility 93,202 N/A  Medical Facility - Inpatient 628,900 N/A Census Region  Midwest 182,777 3.75  South 297,254 3.77  Northeast 219,262 5.20  West 235,476 5.02