Temporal trends and demographic disparities in gastric ulcer mortality in the United States: a population-based study, 1999-2020.

INTRODUCTION

Gastric ulcers are a major subtype of peptic ulcer disease and remain an important cause of morbidity and mortality in the United States, particularly among older adults and high-risk populations. Despite advances in acid-suppressive therapy, Helicobacter pylori eradication, and endoscopic management, recent national patterns in gastric ulcer-related mortality have not been fully characterized.

METHODS

Mortality data from 1999 to 2020 were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database. Deaths with gastric ulcer (ICD-10 code K25) were included. Crude and age-adjusted mortality rates were calculated. Temporal trends were assessed using Joinpoint regression to estimate annual percent changes. Analyses were stratified by age, sex, race/ethnicity, geographic region, urbanization level, and place of death.

RESULTS

A total of 47 082 gastric ulcer-related deaths were recorded, with an overall mean AAMR of 0.65 per 100 000 population. Mortality increased markedly with age, peaking among adults aged ≥85 years. Rates were higher in men than in women and varied substantially by race/ethnicity. National mortality declined significantly from 1999 to 2009, stabilized through 2017, and increased significantly from 2017 to 2020. Higher mortality was consistently observed in non-metropolitan areas and in the West and Midwest regions.

CONCLUSION

Although gastric ulcer-related mortality declined during the early 21st century, recent increases and persistent demographic and geographic disparities highlight emerging challenges related to aging, multimorbidity, and healthcare access. Targeted prevention and timely management are needed to reduce avoidable deaths.