S3181 Demographic and Regional Mortality Trends in Cardiovascular Disease Patients With Coexisting Gastric Cancer in the United States, 1999-2020: A CDC WONDER Analysis

Introduction: Gastric cancer remains a leading global malignancy. Although advancements in diagnosis and therapy have improved outcomes, patients with gastric cancer face an increased risk of cardiovascular disease (CVD)-related mortality. This study analyzed trends and disparities in mortality rates due to gastric cancer ICD-10 (16.1-16.6, 16.8, 16.9) and CVD ICD-10 (100-199) among adults aged 25 years and older from 1999 to 2020. Methods: Retrospective analysis was conducted using mortality data from the CDC WONDER database (1999 to 2020). We calculated age-adjusted mortality rates (AAMRs) per 100,000 individuals, stratified by year, sex, race, region, and place of death. Trends were evaluated using annual percentage change (APC) and the average annual percentage change (AAPC). Results: Between 1999 and 2020, CVD in individuals with gastric cancer caused 74,235 deaths. The overall AAMR decreased from 2.26 in 1999 to 1.34 in 2020 with an AAPC of -2.61 (95% confidence interval [CI] -2.85 to -2.38). A significant decrease occurred from 1999 to 2014 (APC -3.58; 95% CI -4.05 to -3.25), followed by a non-significant decline from 2014 to 2020 (APC -0.15; 95% CI -1.25 to 2.31). Men had a higher AAMR than women (2.20 vs 1.10), though both showed similar declines (female AAPC -2.87; 95% CI -3.31 to -2.47; male AAPC -2.76; 95% CI -3.13 to -2.49). AAMRs varied among racial groups, with non-Hispanic (NH) Black having the highest AAMR (3.25), followed by NH Asian (3.18), Hispanics (2.78), NH American (1.97) and NH Whites (1.16). AAMRs decreased across all races, except for a non-significant rise in NH Black from 2018 to 2020 (APC 4.26; 95% CI -3.31 to 8.01). Geographically, the Northeast had the highest AAMR (2.02), and the Midwest had the lowest (1.08). Hawaii (3.16) and New York (3.09) had the highest state-level AAMRs, while Utah (0.68) and Montana (0.62) had the lowest. Large metropolitan areas had a higher AAMR (1.81) compared to small/medium metropolitan (1.29) and non-metropolitan areas (1.28), though all saw a pronounced decline in mortality from 1999 to 2020. Most deaths occurred in medical facilities (41.82%). Conclusion: Despite an overall decline in CVD-related mortality among gastric cancer patients over the past 2 decades, the rate of decline has slowed in recent years. The highest mortality burdens were observed among males, NH Blacks, urban residents, and individuals in the Northeast. These disparities highlight the need for targeted public health efforts to improve outcomes in high-risk populations.