Trends and disparities in mortality from malignant neoplasms of digestive system and renal failure in the United States, 1999-2023.

11135 Background: Malignancies of the digestive system represent a substantial global health burden, often exacerbated by coexisting renal failure, which complicates therapeutic interventions and significantly elevates mortality risk. This study aims to analyze and interpret annual mortality trends and disparities among adults in the United States from 1999 to 2023, for various demographic and geographic factors. Methods: The mortality data from the CDC WONDER multiple cause of death files for adults aged ≥25 years were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 1,000,000 through ICD 10 code: C15-C26 (digestive system malignant neoplasms) and ICD 10 code: N17-N19 (renal failure), stratified by year, gender, race/ethnicity, place of death and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: From 1999 to 2023, a total of 164,004 deaths were reported due to malignant neoplasms of the digestive system and renal failure, mostly occurring in medical facility inpatient settings. The overall AAMR increased from 27.58 in 1999 to 36.84 in 2023 (AAPC: 1.17; 95% CI: -0.01 to 2.36; p = 0.05), with an initial decline observed between 2011 and 2017 (APC: -4.91; p < 0.001), followed by a notable increase through 2023 (APC: 8.26; p < 0.001). Men are noted to have higher AAMR than women (42.40 vs 19.19). Adults aged 65 and above experienced the highest CMR (110.96), whereas adults aged 45–64 years exhibited the greatest annual increase (3.19%; p < 0.001). By race, the highest AAMR was among non-Hispanic (NH) Black individuals (53.41), and the lowest was among NH White individuals (25.73). Geographic disparities were evident, with the West region having the highest AAMR (31.80) and the Northeast region having the lowest AAMR (27.77). Non-metropolitan areas showed higher AAMR than metropolitan areas (29.42 vs 27.91). At the state level, the District of Columbia and South Dakota ranked highest, placed in the top 90th percentile during 1999–2020 and 2021–2023, respectively. Conclusions: Mortality related to malignant neoplasms of the digestive system and renal failure has increased over the past two decades, with disproportionate burden among older adults, men, NH Black individuals, those living in non-metropolitan areas, and the West region, underscoring the need for targeted prevention, early detection, and equitable, integrated care. Average annual percent change (AAPC) of neoplasms of digestive system and renal failure related age-adjusted mortality rates in the United States, 1999 to 2023. Variable Deaths AAPC (95%CI) Overall 164,004 1.17 (-0.01 to 2.36)