From liver to life: The overlooked impact of MASLD on digestive cancer outcomes.

e23070 Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is an increasing public health concern with the potential to increase the development of malignancy of the digestive tract and beyond. We aim to explore mortality trends of digestive cancer (DC) among MASLD patients. Methods: The CDC WONDER database was examined to extract age-adjusted mortality rates (AAMR) regarding DC among MASLD patients aged 25 years and older between 1999 and 2020. Data was stratified by age, gender, race, and U.S geographic regions. Results: 67616 deaths were documented from 1999 to 2020, with an overall AAPC of 2.8 (95% CI 1.99 to 3.62) and total AAMR of 13.6 (95%CI 13.5 to 13.7). Males showed higher mortality rates than females with an overall AAMR of 22.1 (95%CI 21.9 to 22.3). However, female gender showed higher AAPC with value of 3.6 (95%CI 2.88 to 4.32). Slight difference of AAPC between patients aged 55-64 and over 85 years as they showed the highest AAPC with value of 4.23 (95%CI 3.23 to 5.24) and 4.21 (95%CI 2.31 to 6.14) receptively. White race accounted for the highest AAPC followed by African American with 3.11 (95%CI 2.18 to 4.06) and 1.73 (95%CI 0.33 to 3.15) respectively. Conclusions: The highest AAPC was observed among Whites, older males, large central metropolitan residents and West residents. The observed disparities suggest the importance of improving outcomes for DC patients, particularly with MASLD. Keywords: Digestive cancer, MASLD, CDC WONDER, AAPC. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for digestive cancer among MASLD patients in the United States between 1999 and 2020. Variable Deaths (n) AAMR (95% CI) Overall 67,616 13.6 (13.5 to 13.7) Gender Female 22,396 8.3 (8.2 to 8.5) Male 30,529 14.7 (14.5 to 14.9) Race/Ethnicity Non- Hispanics 56,470 1.24 (1.23 to 1.25) Hispanics 10,552 2.6 (2.55 to 2.65) Geographic Region Northeast 10,571 11.3 (9.8 to 12.8) Midwest 12,154 11.1 (8.7 to 15.1) South 26,646 14.5 (8.8 to 19.7) West 18,245 16.9 (11.3 to 21.5)