S3049 Trends and Disparities in Small Intestinal Carcinoma Mortality in the United States Between 1999-2020

Introduction: To determine the trends and disparities in small intestinal carcinoma mortality in American adults older than 45 years between 1999-2020. Methods: Retrospective analysis of Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was performed. For small intestinal carcinoma, International Classification of Diseases-10 code C17 was employed. Age-adjusted mortality rates (AAMR) and crude death rates (CDR) per 100,000 persons were determined. Average annual percentage change (AAPC) was determined using Joinpoint regression. Temporal trends were analyzed in sex, race, geographical distribution and patient age-related mortality. Results: A total of 27,320 deaths from small intestinal carcinoma were reported. AAMRs declined slightly from 1.02 to 0.96 between 1999-2013 (AAPC: -0.08; P = 0.75) followed by a steady increase from 0.96 to 1.21 between 2013-2020 (AAPC: 3.25; P < 0.001), resulting in overall AAMR of 1.05 (AAPC: 1.02; P < 0.001). Men had higher AAMR (1.28) as compared to women (0.85) and both showed a similar increase in mortality (men AAPC: 0.73; P = 0.019 and women AAPC: 0.73; P = 0.1). Among races, non-Hispanic (NH) Blacks had the highest AAMR (1.72), followed by NH Whites (1.05), NH American Indians/Alaskan Natives (0.81), Hispanics (0.75), NH Asian/Pacific Islanders (0.7). All races saw an increase in AAMR, with the greatest increase seen in NH Blacks (AAPC: 1.49; P < 0.001). Geographically, AAMRs were highest in Midwest (1.12) followed by Northeast (1.07). All census regions saw an increase in AAMR, with the greatest increase seen for South (AAPC: 1.12; P = 0.015). Metropolitan areas showed disproportionately higher mortality (AAMR: 1.07) in comparison to nonmetropolitan areas (AAMR: 1.02). Additionally, they showed a greater increase in AAMR (AAPC: 1.08; P = 0.001) than nonmetropolitan areas (AAPC: 0.57; P = 0.29). Of the 10-year age groups, CDR was highest for 85+ years (3.61). All age groups saw an increase in CDR except 45-54 years which saw a decline (AAPC: -1.63; P = 0.031). The greatest increase was seen for 85+ years (AAPC: 1.73; P < 0.001). Conclusion: We found a significant increase in small intestinal carcinoma mortality, though persistent disparities exist. Males, NH Blacks, residents of Midwest and metropolitan areas experienced disproportionately higher mortality rates. While all demographics saw an increase in AAMR from 1999-2020, those aged 45-54 years saw a decline. These findings identify critical areas for targeted public health interventions.