S3197 Trends of Recent Years With Future Forecasting of Peptic Ulcer Mortality in the United States (1999-2035)

Introduction: Peptic ulcer disease (PUD) remains a notable health concern in the U.S., with shifting mortality trends across regions and demographics. Despite treatment advances, ongoing surveillance and targeted interventions are essential. Methods: Data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) were analyzed for peptic ulcer disease ICD-10 codes K25-K26 in adults aged over 25 years from 1999 to 2023. Age-adjusted mortality trends were assessed using Joinpoint regression, and future rates were forecasted using an optimal autoregressive integrated moving average (ARIMA) model. Results: From 1999-2023, peptic ulcer disease (PUD) caused 116,669 deaths in the U.S., with age-adjusted mortality rates (AAMRs) declining from 3.2 to 2.18 per million (AAPC -1.68%; P = -0.76). Forecasts using an ARIMA model showed a slower decline (AAPC -0.18%; P = 0.06), with rates rising from -0.475 in 2024 to 0.015 by 2035. Age-specific analysis was limited due to unreliable data. Male AAMRs declined from 4.1 to 2.69 (AAPC -1.65%; P = 0.00) and female from 2.61 to 1.77 (AAPC -1.76%; P = 0.01). All races showed declining AAMRs except American Indian/Alaska Native, which rose from 1.89 to 2.22 (AAPC -3.00%; P = 0.66). White and Black populations saw declines, with Whites showing the highest increase in APC (-6.76% to 3.26%). All U.S. regions had declining AAMRs: Northeast (2.76-1.72), Midwest (3.32-2.21), South (2.94-2.00), and West (4.1-2.82), with the Northeast showing the largest APC increase. In 2020, AAMRs were higher in non-metropolitan areas (4.9) than in metropolitan areas (3.9). States with the highest mortality included California, the District of Columbia, Oregon, and others; Massachusetts had the lowest. Most deaths occurred in inpatient facilities (66,877), followed by homes (13,053). Conclusion: From 1999-2023, PUD mortality trends varied across groups, with notable increases among men, American Indians, and those in the Northeast. Deaths rose in both urban and rural areas, especially in the Northeast and Midwest. Most occurred in inpatient settings, underscoring the need for improved access and targeted interventions to reduce mortality in high-risk groups.