S2938 Trends and Regional Disparities in Congenital Digestive Anomalies in the United States, 1990–2021

Introduction: A nationwide assessment was performed to track the burden of congenital digestive anomalies in the United States from 1990 to 2021 using standardized global burden of disease study 2021 framework. Age-standardized rates of prevalence, mortality, and disability-adjusted life years (DALYs), years lived with disability (YLDs) were analyzed per 100,000 population. Long-term trends were evaluated by calculating annualized percentage change (APC) using log-linear regression. All estimates were derived from globally harmonized epidemiological datasets and are presented with 95% uncertainty intervals. Methods: A nationwide assessment was performed to track the burden of congenital digestive anomalies in the United States from 1990 to 2021 using standardized global burden of disease study 2021 framework. Age-standardized rates of prevalence, mortality, and disability-adjusted life years (DALYs), years lived with disability (YLDs) were analyzed per 100,000 population. Long-term trends were evaluated by calculating annualized percentage change (APC) using log-linear regression. All estimates were derived from globally harmonized epidemiological datasets and are presented with 95% uncertainty intervals. Results: Between 1990 and 2021, the age-standardized incidence rate (ASIR) for congenital digestive anomalies in the United States increased by 0.58% annually, while the prevalence rate (ASPR) declined by 0.27%. The burden measured by age-standardized DALYs (ASDALR) and YLDs (ASYLDsR) decreased by 1.16% and 0.26%, respectively. Subnationally, the highest increase in ASIR was noted in Maine (APC: 1.57%), followed by Delaware (1.41%), Tennessee (1.32%), and Georgia (1.32%). ASPR was highest in Maine (0.33%), West Virginia (0.21%), and Montana (0.09%). Age-wise, the greatest prevalence was seen in the 2–4 years age group (17,456 [95% UI: 13,787–21,756]), while the highest DALY burden occurred in neonates aged 0–6 days (15,074 [11,725–17,929]). Males consistently exhibited a higher burden than females, with a steeper rise in ASIR (0.9% vs 0.19%) and a slightly slower decline in ASYLDsR (–0.21% vs –0.3%). Conclusion: While mortality from congenital digestive anomalies has declined in the U.S., the overall burden remains substantial due to persistent disability and demographic disparities. Targeted interventions focused on early diagnosis, surgical access, and long-term follow-up are essential to reduce avoidable disability and ensure equitable outcomes.