S1423 Trends in Mortality From Gastrointestinal Hemorrhage in Patients With Colorectal Cancer: Insights From CDC WONDER (2018–2023)

Introduction: Colorectal Cancer is the second leading cause of cancer-related deaths. GI Hemorrhage (GIH) is a significant complication of CRC that presents as a serious life-threatening emergency, which increases morbidity and mortality risk. Although GIH associated with CRC is clinically severe, the data on recent national mortality trends are insufficient. This study attempts to bridge the gap through recent nationwide mortality data in the United States, and it will be valuable in guiding treatment plans and public health priorities. Methods: A retrospective analysis using data from the CDC WONDER database (2018-2023) for colorectal cancer deaths, which were identified using ICD-10 codes for colorectal cancer (C18.0-C20) and gastrointestinal hemorrhage (K92.2). Crude and age-adjusted death rates per 100000 were estimated for each year, and we examined trends over time using linear regression and also estimated average annual percent change (AAPC) by sex. Results: A total of 5,605 deaths were recorded between 2018 and 2023. The number of deaths increased, from 849 (370 in women, 479 in men) in 2018 to 1,047 (464 in women, 583 in men) in 2023. Over the years, the annual crude and age-adjusted mortality rates were stable at 0.3 deaths per 100,000 and 0.2 deaths per 100,000, respectively. The AAPC did not show any significant trend. For all years, men consistently had higher crude and age-adjusted mortality rates than women. Conclusion: The increase in the number of deaths from GIH in CRC patients shows a rising healthcare cost and resource allocation. However, the crude and age-adjusted mortality rates of GIH associated with CRC patients remain stable; thus, the increase in deaths is not reflected by an increase in population-level risk. Future research should consider risk stratification by analyzing demographics and tumor characteristics, and the role of screening and bleeding risk reduction strategies in decreasing mortality rates.