ArticleGastroenterology2022
Factors Associated With Geographic Disparities in Gastrointestinal Cancer Mortality in the United States.
Article in Gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Area-level socioeconomic status is associated with colorectal cancer screening, incidence and mortality in the US: a systematic review and meta-analysis.Social science & medicine (1982) · 2025Pooled it
- Characterizing gastric cancer and time-to-first treatment among non-Hispanic American Indian Alaska Native and white patients in North Carolina.Cancer causes & control : CCC · 2026Article
- The Changing Face of Gastrointestinal Cancer Mortality: Trends and Divide by Age and Geography.Annals of surgical oncology · 2026Article
- Race and Socioeconomic Status Impact Survival from Early and Late-Onset Colorectal Cancer.medRxiv : the preprint server for health sciences · 2026Article
- Trends in mortality from cancer and sepsis in the United States, 1999 to 2023: An analysis of CDC WONDER data.Medicine · 2026Article
- Multilevel insights into obesity, race/ethnicity, and survival in early-onset colorectal cancer in Georgia.Cancer causes & control : CCC · 2026Article
- Differential gastrointestinal mortality in Native Hawaiian/Pacific Islander and Asian subgroups in the U.S.: a cross-sectional analysis of national mortality surveillance data 2018-2023.Lancet regional health. Americas · 2026Article
- Understanding Cancer Health Disparities.Cancers · 2026Review
- Outcomes Among Patients With Colon Cancer Living in Neighborhoods With Persistent Poverty.JAMA network open · 2026Article
- Trends in liver failure-related mortality among middle-aged and older adults with digestive system malignant tumors in the United States, 1999-2023.Frontiers in oncology · 2026Article
- Population ageing and gastric cancer mortality burden in China, 2008-2021: a nationwide analysis with projections to 2036.Frontiers in public health · 2026Article
- Trends in pancreatic cancer mortality among US adults, 1999-2023.BMC gastroenterology · 2025Article
- Providers' and Survivors' Perspectives on Affordability Challenges for Gastrointestinal Cancer Treatment in Two Low Socioeconomic Status States of the Southern United States.Cancer medicine · 2025Article
- Geographic disparities in gastrointestinal oncology research: a focus on trial availability in Italy.The oncologist · 2025Article
- Associations of Social Vulnerability and Race-Ethnicity With Gastrointestinal Cancers in the United States.Cancer medicine · 2025Article
- Burn the Fat: Colon Cancer Tumors Are Skilled at Lipid Storage During Obesity.Gastroenterology · 2025Article
- Common Risk Factors in Gastrointestinal Cancers: A Narrative Review.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2025Review
- Rising Mortality among Non-Hispanics due to Pancreatic Cancer in the United States. A CDC Database analysis.Journal of gastrointestinal cancer · 2024Article
- Association of county level poverty with mortality from primary liver cancers.Cancer medicine · 2024Article
- Unravelling the role of intratumoral bacteria in digestive system cancers: current insights and future perspectives.Journal of translational medicine · 2024Review
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8 authors.
Funding
Abstract
BACKGROUND &
aimsSignificant geographic variability in gastrointestinal (GI) cancer-related death has been reported in the United States. We aimed to evaluate both modifiable and nonmodifiable factors associated with intercounty differences in mortality due to GI cancer.
methodsData from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research platform were used to calculate county-level mortality from esophageal, gastric, pancreatic, and colorectal cancers. Multivariable linear regression models were fit to adjust for county-level covariables, considering both patient (eg, sex, race, obesity, diabetes, alcohol, and smoking) and structural factors (eg, specialist density, poverty, insurance prevalence, and colon cancer screening prevalence). Intercounty variability in GI cancer-related mortality explained by these covariables was expressed as the multivariable model R
resultsThere were significant geographic disparities in GI cancer-related county-level mortality across the US from 2010-2019 with the ratio of mortality between 90th and 10th percentile counties ranging from 1.5 (pancreatic) to 2.1 (gastric cancer). Counties with the highest 5% mortality rates for gastric, pancreatic, and colorectal cancer were primarily in the Southeastern United States. Multivariable models explained 43%, 61%, 14%, and 39% of the intercounty variability in mortality rates for esophageal, gastric, pancreatic, and colorectal cancer, respectively. Cigarette smoking and rural residence (independent of specialist density) were most strongly associated with GI cancer-related mortality.
conclusionsBoth patient and structural factors contribute to significant geographic differences in mortality from GI cancers. Our findings support continued public health efforts to reduce smoking use and improve care for rural patients, which may contribute to a reduction in disparities in GI cancer-related death.
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