S3048 Trends and Disparities in Duodenal Ulcer Mortality in the United States Between 1999-2020

Introduction: To determine the trends and disparities in duodenal ulcer 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 duodenal ulcer, International Classification of Diseases-10 code K26 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 28,134 deaths from duodenal ulcers were reported. AAMRs declined sharply from 1.5 to 0.97 between 1999-2008 (AAPC: -5.75; P < 0.001) followed by a slight increase from 0.97 to 0.99 between 2008-2018 (AAPC: 0.4; P = 0.46) and a sharper increase from 0.99 to 1.2 between 2018-2020 (AAPC: 10.33; P = 0.07), resulting in an overall AAMR of 1.06 (AAPC: -1.4; P = 0.014). Men had higher AAMR (1.35) as compared to women (0.83) and showed a greater decline in mortality (AAPC: -1.95; P < 0.001) than women (AAPC: -0.88; P = 0.38). Among races, non-Hispanic (NH) Whites had the highest AAMR (1.11) followed by NH Blacks (0.93), NH Asian/Pacific Islanders (0.92), NH American Indians/Alaskan Natives (0.79), and Hispanics (0.66). All races saw a decline in AAMR, with the greatest decline seen in NH Asian/Pacific Islanders (AAPC: -2.78; P = 0.017). Geographically, AAMRs were highest in West (1.37) followed by Midwest (1.09). All census regions saw a decline in AAMR, with the greatest decline seen for Northeast (AAPC: -1.88; P = 0.006). Nonmetropolitan areas showed a slightly higher AAMR (1.09) than metropolitan areas (1.05), although metropolitan areas saw a greater decline in AAMR (AAPC: -1.47; P = 0.079) than nonmetropolitan areas (AAPC: -1.27; P = 0.008). Of the 10-year age groups, CDR was highest for 85+ years (6.94). All age groups saw a decline in CDR, with the greatest decline seen for 85+ years (AAPC: -2.31; P < 0.001) followed by 75-84 years (AAPC: -1.46; P = 0.198). Conclusion: We found a significant decline in duodenal ulcer mortality, though persistent disparities exist. Elderly males, NH Whites, residents of West and nonmetropolitan areas experienced disproportionately higher mortality rates. These findings emphasize the need for targeted interventions to address disparities and reduce mortality.