ArticleBMC public health2026
Spatiotemporal trends, demographic disparities, and predictions to 2040 in gastrointestinal cancer mortality in the United States.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGastrointestinal cancers represent a major public health challenge in the United States, yet the latest mortality trends and population disparities remain unclear. This study aimed to systematically analyze the demographic disparities and spatiotemporal trends in age-adjusted mortality rates (AAMR) of six gastrointestinal cancers in the United States from 1999 to 2023, and to project their mortality trends through 2040.
methodsData were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and the Global Burden of Disease (GBD) Study 2021. Joinpoint regression analysis were used to evaluate the annual percent change (APC) and average annual percent change (AAPC) for gastrointestinal cancers, stratified by sex, race/ethnicity, age group, census region, and state. The autoregressive integrated moving average (ARIMA) model was used to forecast mortality rates by 2040.
resultsOverall, except for liver cancer (LC) and pancreatic cancer (PC), the AAMR of the remaining gastrointestinal cancers showed downward trend. LC had the highest AAPC (1.58, 95% CI: 1.51 to 1.64), while gastric cancer (GC) had the lowest AAPC (-2.48, 95% CI: -2.59 to -2.36). By sex, males had higher AAMR than females for gastrointestinal cancers except biliary tract cancer, with esophageal cancer showing the most significant disparity. By race/ethnicity, Non-Hispanic Black individuals had the highest colorectal cancer mortality, whereas non-Hispanic White individuals exhibited the fastest increase in LC mortality. By age, crude mortality rates peaked in adults ≥ 85 years. Projections to 2040 indicated that GC would experience the largest decline in mortality rates, while the mortality rates of LC and PC will continue to rise.
conclusionWhile overall gastrointestinal cancer mortality in the United States has declined, LC and PC burdens continue to rise, with significant disparities by race, region, and age, highlighting the need for targeted prevention and control measures.
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