Trends in gastrointestinal cancer and metabolic syndrome mortality in the US (1999–2023).

e23054 Background: Gastrointestinal (GIT) cancers and metabolic syndrome contribute significantly to mortality. This study examines trends in mortality from 1999 to 2023, stratified by demographic and geographic factors to identify disparities. Methods: CDC WONDER data for U.S. adults aged 25+ from 1999 to 2023 were analyzed. Age-adjusted mortality rates (AAMRs) per million were calculated across gender, race, age groups, and census regions. Trends were evaluated using Joinpoint regression to compute average annual percentage change (AAPC) with 95% confidence intervals (CIs) and p-values. Results: GIT cancers and metabolic syndrome caused 468,086 deaths from 1999 to 2023. AAMRs rose from 63/million (95% CI 61.83–64.17) in 1999 to 105.31/million (95% CI 104.1–106.52) in 2023 (AAPC: 1.95%; 95% CI 1.67–2.29; p &lt; 0.000001). Males had higher mortality (259,865 deaths; AAMR: 102.04/million) than females (208,221 deaths; AAMR: 61.77/million), with AAPCs of 2.13% (95% CI 1.89–2.44; p &lt; 0.000001) and 1.59% (95% CI 1.26–1.99; p &lt; 0.000001), respectively. Blacks and American Indians had the highest AAMRs (122.19/million and 96.34/million, respectively). Whites showed the steepest AAMR increase (AAPC: 2.46%; 95% CI 2.12–2.88; p &lt; 0.000001). Adults aged 75+ exhibited the highest AAMR (605.61/million, 2021–2023; AAPC: 1.64%; 95% CI 1.30–2.00; p &lt; 0.000001). The South had the highest mortality (172,025 deaths; AAMR: 124.11/million in 2023) and the most pronounced increase (AAPC: 3.53%; 95% CI 3.19–4.03; p &lt; 0.000001). Conclusions: Mortality from GIT cancers and metabolic syndrome has risen significantly, with disparities by gender, race, and geography. Targeted public health interventions are urgently needed, especially for males, Blacks, and residents of the South. Cohort Age Adjusted Mortality Rate per million Average Annual Percentage Change 95% Confidence Interval P- Value 1999-2020 2021-2023 Overall 79.45 104.37 1.9487* 1.6682 to 2.2871 &lt; 0.000001 Males 102.04 137.47 2.1346* 1.8893 to 2.4377 &lt; 0.000001 Females 61.77 77.09 1.5854* 1.2637 to 1.9942 &lt; 0.000001 American Indian or Alaska Native 96.34 124.87 1.9041* 1.3074 to 2.7395 &lt; 0.000001 Asian or Pacific Islander 75.19 77.7 -0.1557 -0.4393 - 0.1992 0.375125 Black or African American 122.19 137.13 0.7840* 0.3367 to 1.4804 0.003199 White 73.39 104.7 2.4611* 2.12 to 2.8801 &lt; 0.000001 Hispanic or Latino 89.73 106.44 1.2193* 0.904 to 1.6191 &lt; 0.000001 Ages 25-54 5.77 10.19 4.3353* 3.9483 to 4.7028 &lt; 0.000001 Ages 55-74 122.59 173.1 2.3220* 2.1322 to 2.5572 &lt; 0.000001 Ages 75+ 498.5 605.61 1.6373* 1.3026 to 2.0005 &lt; 0.000001 Northeast 73.46 77.78 0.5468* 0.2972 to 0.8622 0.002799 Midwest <jats:td colspan="1" rowspan