Gastric Cancer Mortality in the United States: A Two-Decade Analysis of Trends and Disparities (1999-2020).

[OBJECTIVES] Gastric cancer mortality has declined in recent decades, yet sociodemographic disparities remain. This study analyzed national trends in gastric cancer mortality among US adults, with stratification by demographic and geographic factors.

[METHODS] We examined gastric cancer deaths (ICD-10 C16) in adults aged ≥25 years using CDC WONDER data from 1999 to 2020. Mortality trends were analyzed by age, sex, race/ethnicity, region, and urbanization using joinpoint regression to calculate annual and average annual percent changes (APC, AAPC).

[RESULTS] From 1999 to 2020, there were 276,023 gastric cancer deaths. Mortality declined more in males (AAPC: -2.97 [95% CI: -3.15 to -2.79]) than females (-2.42 [-2.64 to -2.21]). The largest declines were among Asians (-3.83 [-4.08 to -3.56]) and Blacks (-3.25 [-3.49 to -3.02]), followed by Whites (-2.96 [-3.13 to -2.87]) and Hispanics (-2.31 [-2.58 to -2.06]). Metropolitan areas saw greater declines (-2.72 [-2.83 to -2.62]) than rural areas (-2.41 [-2.68 to -2.12]). By region, the Northeast showed the steepest decline (-3.16 [-3.34 to -2.99]), followed by the Midwest, South, and West. Notably, mortality increased among adults aged 25 to 34 years (AAPC: 0.38 [-1.24 to 2.70]) and 35 to 44 years (0.87 [0.12 to 1.73]).

[CONCLUSIONS] Gastric cancer mortality declined overall but with persistent disparities. Rising rates among younger adults and slower declines in rural and western regions warrant further investigation and targeted interventions.