Mortality trends from malnutrition and gastrointestinal cancer in US adults: A retrospective analysis.

Abstract

e15675 Background: Gastrointestinal cancer is the significant public health issue worldwide, contributing to a substantial cancer related death. Malnutrition, a complex multifactorial condition linked to higher morbidity and mortality. This study aimed to investigate the mortality trends and disparities among malnourished and gastrointestinal cancer patients in the United States. Methods: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause-of-Death database. We analyzed average age adjusted mortality rates (AAMRs) from 1999 to 2023 per 1,000,000 population using ICD−10 codes for malnutrition (E40-E46) and gastrointestinal cancer (C15-C26). Data were extracted using demographic characteristics (sex, race/ethnicity, and age), U.S. census region, and metropolitan status. Join-point regression program was utilized to evaluate annual percentage changes (APC) and average annual percentage change (AAPC) with 95% confidence intervals. Results: Over 24 years, 60,016 deaths involved malnutrition and gastrointestinal cancer. The overall AAMR increased from 1999 to 2023 (AAMR: 10.2, 95% CI: 9.76 to 10.64; AAPC: 2.99, 95% CI: 2.39 to 3.62). Men had higher rates than women (13.06 vs. 7.86). Among races, the highest AAMR was observed in Non-Hispanic Black (16.02), followed by Hispanic (10.26), Asian/Pacific Islanders (9.72), and White (9.54). Regionally, the West had the highest rates (11.26), then Midwest (11.12), South (10.84), and Northeast (6.58). Stratified by urbanization, rural areas showed higher AAMRs (11.05) than urban areas (8.55). Conclusions: Mortality from concurrent malnourishment and gastrointestinal cancer has increased overall and remains highest among males, Black populations, Western region, and residents of rural areas which could be due to low resources, poverty and poor healthcare system as compared to urban. These disparities highlight the urgent need for targeted, equitable public health interventions to reduce mortality in these vulnerable groups. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for trends related to malnutrition and gastrointestinal cancer mortality in adults in the United States between 1999 and 2023. Variable Deaths (n) AAMR (95% CI) in 2023 Overall 60,016 19.08 (18.78-19.38) SEX Female 26,048 15.98 (15.33-16.62) Male 33,968 27.49 (26.57-28.42) RACE/ETHNICITY NH Asians 2,294 15.73 (13.72-17.74) NH Blacks 8,840 27.82 (25.84-29.81) NH White 43,015 21.04 (20.39-21.69) Hispanics 5,161 19.02 (17.43-20.62)