S2979 Rising Cerebrovascular Disease-Related Mortality and Healthcare Disparities Among Patients With Gastrointestinal Malignancies in the United States (1999-2020): A Population-Based Analysis

Introduction: Malignant neoplasm of the digestive tract is one of the major contributors to cancer related deaths in the United States. The burden of cerebrovascular diseases in these patients remains rather understudied despite potential links through inflammation, treatment effects and shared risk factors. This study analyses the national mortality trends using the CDC Wonder Data Base to identify at risk groups and guide public health strategies. Methods: We conducted a retrospective cohort analysis of mortality data for adults with cerebrovascular disease with digestive tract malignancies using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC wonder) database from 1999 to 2020. These data are produced by the national center for health statistics. ICD-10 codes (CVD: I60-I69; GIT malignancy: C15-C26). Age-adjusted mortality (AAMR) and annual percentage change were calculated using the Join Point regression program. Results: Between 1999 and 2019, 81,958 cerebrovascular disease (CVD)-related deaths among patients with gastrointestinal malignancy were reported. The overall AAMR from 1999 to 2020 initially declined, then rose, reaching 17.2 per 1,000,000 in 2020. Men had higher mortality than women (AAMR: 21.9 vs 13.4). By race, non-Hispanic (NH) Black individuals had the highest mortality (AAMR: 23.0), followed by White (16.7) and Hispanic (15.5) populations. AAMR varied by region; the Midwest (17.8) and South (17.4) had the highest rates, and rural noncore areas had the highest urbanization-specific rate (17.9). A reversal in trend was observed across nearly all subgroups post-2015. Join point analysis showed significant annual percentage change increases in men (6.12%), Black individuals (6.14%), micropolitan regions (8.83%), rural noncore areas (3.46%), and the South (6.01%) (P < 0.05). Conclusion: Our analysis reveals a concerning rise in cerebrovascular disease-related mortality among patients with gastrointestinal malignancies in recent years, particularly following 2015. This upward trend is especially pronounced among men, Black individuals, and residents of micropolitan and rural regions. These findings underscore widening healthcare disparities in this vulnerable population. Targeted efforts to improve cerebrovascular risk assessment, prevention, and management in patients with GI cancers are urgently needed to address these emerging trends.