S440 Mortality Trends in Diverticular Intestinal Disease in the United States: A Population-Based CDC Study

Introduction: Intestinal diverticular disease is generally benign but can cause severe complications leading to mortality. This study analyzes national mortality trends and demographic disparities related to diverticular disease in the U.S. from 1999 to 2020. Methods: A retrospective analysis of CDC WONDER mortality data (1999–2020) was conducted. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Trends were assessed using annual percent change (APC), stratified by age, sex, race/ethnicity, region, and urbanization status. Results: From 1999 to 2020, 115,009 deaths were attributed to diverticular disease. The overall AAMR was 2.413 (95% confidence interval [CI]: 2.399–2.427), declining from 3.634 (95% CI: 3.545–3.723) in 1999 to 1.935 (95% CI: 1.882–1.988) in 2020. Mortality rates decreased steadily from 1999 to 2018 (APC ranging from -2.51 to -5.21), followed by a rise from 2018 to 2020 (APC: 3.12). Age-stratified data showed the highest mortality among those aged 85+, followed by 75–84 and 65–74 years. The 85+ group had a significant decline in mortality from 1999 to 2014 (APC: -5.13), with no significant change after 2014. Middle-aged adults (55–64 years) experienced a mortality decline until 2015 (APC: -2.56), then a significant increase (APC: 4.42). Younger adults (35–44 years) showed a slight, non-significant increase, while the 45–54 age group had a small but significant decline. Women exhibited higher mortality (AAMR: 2.63) compared to men (AAMR: 2.061). Among racial/ethnic groups, non-Hispanic (NH) Whites had the highest mortality (AAMR: 2.507), followed by NH Black or African Americans (2.098), Hispanics or Latinos (1.715), American Indians or Alaska Natives (1.45), and NH Asians or Pacific Islanders (0.813). Geographically, the Midwest and West regions reported the highest mortality rates (AAMR: 2.6 for both), followed by the South and Northeast (AAMR: 2.3 each). Mortality was higher in non-metropolitan areas (AAMR: 2.9) compared to metropolitan areas (AAMR: 2.3). At the state level, West Virginia ranked in the 90th percentile for mortality, whereas Hawaii was in the tenth percentile. Conclusion: Diverticular disease-related mortality in the U.S. has significantly declined from 1999 to 2018 but showed a recent increase through 2020. Marked disparities exist by age, sex, race/ethnicity, and region. These findings emphasize the need for targeted public health strategies to address disparities and improve outcomes, especially in underserved populations.