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The Changing Face of Gastrointestinal Cancer Mortality: Trends and Divide by Age and Geography

Year: 2026

Type: article

Abstract: National Center for Health Statistics GI cancer mortality data were obtained from SEER*Stat, version 9.0.41.4. Age-adjusted mortality rates (2000 U.S. standard population) were analyzed from 1990 to 2023 for younger adults (age, 20–49 years) and older adults (age, ≥ 50 years) for all GI cancers combined and separately for esophageal, gastric, colorectal (CRC), liver/intrahepatic cholangiocarcinoma (ICC), and pancreatic cancers. The overall percentage change (PC) and the annual percentage change (APC) with 95% confidence intervals (CIs) were derived from SEER*Stat trend analyses. Temporal trends were displayed using age-stratified line graphs and county-level variation with percentile-based heat maps. Because de-identified public data were used, institutional review board approval and informed consent were not required. Among younger adults, overall GI cancer mortality changed little from 1990 to 2023 (APC, − 0.1%; 95% CI − 0.2 to − 0.1%). Colorectal cancer was the only major subtype with worsening mortality, increasing from 1.7 per 100,000 in 2002–2004 to nearly 2.0 per 100,000 in 2019–2023. Mortality declined for esophageal cancer (APC, − 1.1%; 95% CI − 1.3 to − 0.8%), gastric cancer (APC, − 0.7%; 95% CI − 0.9 to − 0.6%), and pancreatic cancer (APC, − 0.5%; 95% CI − 0.6 to − 0.4%). Liver/ICC showed a mixed pattern, with an annual decline from 2002 to 2023, but an overall 10.4% increase from 1990 to 2023 (Table 1 ). Among older adults, overall GI cancer mortality declined more substantially (APC, − 0.9%; 95% CI − 0.9 to − 0.8%). Colorectal cancer declined from approximately 79 per 100,000 in 2002–2004 to 48 per 100,000 in 2019–2023 (APC, − 2.4%; 95% CI − 2.5 to − 2.3%), and gastric cancer mortality also decreased markedly. In contrast, pancreatic cancer increased from about 55 to 60 per 100,000 and surpassed CRC in later years, whereas liver/ICC had the steepest increase (PC, 91.3%; APC, 2.1%; 95% CI 1.9 to 2.3%). County-level maps showed substantial geographic heterogeneity, with clearer clustering in older adults (Fig. 1 ). Higher-mortality counties were concentrated in the South, lower Mississippi Valley, Appalachia, and parts of the Southwest. Similar clustering was seen for CRC and pancreatic cancer. Esophageal cancer showed a stronger eastern/Appalachian pattern, whereas stomach cancer and liver/ICC were more concentrated in the Southwest, the Texas border region, the Gulf Coast, and the Southeast (Supplementary Fle 1 ). Temporal and geographic variations in mortality rates for young versus old-onset gastrointestinal cancers

Source: Annals of Surgical Oncology

DOI: 10.1245/s10434-026-19721-y

Authors: Qaidar Alizai, Timothy M. Pawlik

Institutions: The Ohio State University Wexner Medical Center, The Ohio State University, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

Language: English

Topic: Global Cancer Incidence and Screening

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,590