S101 Mortality Trends and Disparities in Gallbladder Cancer in the United States, 1999 to 2023: An Analysis of CDC WONDER Database

Introduction: Gallbladder cancer is a rare yet aggressive malignancy, accounting for approximately 1.2% of all gastrointestinal cancers in the United States. In this study, we aim to analyze the regional and demographic trends in gallbladder cancer-related mortality among U.S. adults aged ≥25 years from 1999 to 2023. Methods: Mortality data for gallbladder cancer were sourced from the CDC WONDER Multiple Cause of Death database using the ICD-10 code C23. We calculated both crude mortality rates and age-adjusted mortality rates (AAMRs) per 100,000 individuals. Joinpoint regression was used to model temporal trends, estimating the annual percent change and average annual percent change, with 95% confidence intervals. Results: Between 1999 and 2023, 55,383 gallbladder cancer-related deaths occurred in the United States. AAMR significantly declined from 1.28 in 1999 to 0.85 in 2023 (average annual percent change: -1.41%; 95% CI: -1.59 to -1.23). Mortality disparities were striking across various subgroups. Women experienced a higher AAMR than men (1.20 vs 0.74). Racial and ethnic minorities faced elevated rates, with Hispanics at the highest risk (AAMR: 1.57), followed by non-Hispanic (NH) Black (1.39), NH Asian/Pacific Islander (1.16), and NH White (0.87) populations. Regionally, the Northeast reported the highest AAMR (1.12), exceeding the Midwest (1.06), West (0.97), and South (0.91). The state-level burdens were most severe in New York, New Mexico, the District of Columbia, Illinois, and Delaware. Metropolitan areas had higher rates than non-metropolitan areas (AAMR: 1.02 vs 0.95). Adults aged 65 years and older had the highest crude mortality rate (3.87). Conclusion: Despite a significant national decline in gallbladder cancer mortality over 25 years, ongoing disparities across sex, race/ethnicity, age, and geography highlight inequitable burdens. Targeted interventions are crucial to improve early detection, treatment access, and supportive care for disproportionately affected populations.