Trends in mortality and disparities in small intestine neoplasms among U.S. adults aged 65 years and older: A retrospective analysis of 25 years.

Abstract

e15684 Background: Small intestine neoplasms are relatively rare malignancies but contribute to a growing cancer-related mortality burden in the United States, with notable variation across demographic and geographic populations. This study aimed to evaluate temporal trends in age-adjusted mortality rates in adults over 65 years of age due to small intestine neoplasms from 1999 to 2023 and to assess disparities by sex, race/ethnicity, urbanization, geographic region, state, and place of death. Methods: Mortality data was obtained from the Centers for Disease Control and Prevention (CDC) mortality data base. International Classification of Disease (ICD-10) code C17 was used to obtain data. Adults aged ≥65 years were included in this study. Joinpoint regression was used to calculate and (Average Annual Percent Change) values for the entire study period. A p value < 0.05 was considered statistically significant. Results: Between 1999 and 2023, small intestine neoplasms led to 27,203 deaths, with the most deaths being recorded at the decedent's home (44.31%). The AAMR rose from 2.35 in 1999 to 3.17 in 2023 with an associated AAPC of 1.2899 (95% CI: 0.91 to 1.66; p < 0.000001). In 1999, men had an AAMR of 3.08, almost twice as high as women, who had an AAMR of 1.85. These differences became less pronounced over time, and in 2023 men had an AAMR of 3.94 (AAPC: 1.11; 95% CI: 0.60 to 1.62; p = 0.000019), while women had an AAMR of 2.55 (AAPC: 1.22; 95% CI: 0.62 to 1.83; p = 0.000056). Urban areas experienced slightly higher AAMR increases (AAPC: 1.0869*, 95% CI: 0.58 to 1.59 p = 0.00002) than rural areas (AAPC: 0.9411*, 95% CI: 0.32 to 1.56 p = 0.0045). AAMR in urban areas increased from 2.35 in 1999 to 2.93 in 2020, while in rural areas, it increased from 2.27 to 2.68. Non-Hispanic Black individuals experienced the highest AAMR in 2023 at 4.23 (AAPC: 1.6041; 95% CI: 0.96 to 2.24; p = 0.000026), followed by Non-Hispanic White individuals who had an AAMR of 3.11 in 2023 (AAPC: 1.2429; 95% CI: 0.84 to 1.64; p = < 0.000001) and Hispanic or Latino individuals with an AAMR of 2.4 in 2023 (AAPC = 1.2885; 95% CI: -0.50 to 3.11; p = 0.159467) respectively. States with the highest AAMRs included South Dakota (3.49), Iowa (3.47) and Washington (3.31); states with the lowest AAMRs included Wyoming (1.82), Arizona (1.78) and New Mexico (1.74). Geographically, the Midwest had the highest AAMR in 2023 (3.5), followed by the West (3.12), the South (3.1) and the Northeast (2.83). The decedent's home recorded the highest number of deaths (44.31%). Conclusions: Small intestine neoplasm-related mortality has increased significantly from 1999 to 2023, with a disproportionate burden in men, residents of metropolitan areas and Blacks Individuals. Targeted interventions like risk-group-focused prevention, age appropriate care and early screening can help reduce morbidity and mortality and improve clinical outcomes.