Waqas, Muhammad

e20520 Background: Cancer and respiratory failure (RF) are amongst leading causes of mortality in adults. This study investigates national trends in age-adjusted mortality rates (AAMRs) for cancer and RF in the United States from 1999 to 2023, focusing on disparities by gender, race, region, and rural-urban residence to inform public health strategies. Methods: This descriptive study analyzed data from the CDC WONDER database, of adults aged 25 and older. Mortality data were identified using ICD-10 codes C00–C97 (cancer) and J96 (RF). AAMRs per 100,000 population were calculated and stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05. Results: From 1999 to 2023, total deaths of 1,263,368 attributed to cancer and RF (682,141 men, 581,227 women). AAMRs declined from 1999 to 2004 (APC = -1.5, 95% CI: -4.0 to -0.4), stabilized from 2004 to 2012 (APC = 0.8, 95% CI: 0.1 to 2.4), and increased from 2012 to 2023 (APC = 3.2, 95% CI: 2.9 to 3.8). Men experienced a greater initial decline (APC = -2.1, 1999–2004) but significant increases thereafter (APC = 3.0, 2012–2023), while women showed a slower decline followed by sharper increases (APC = 3.5, 2013–2023). Non-Hispanic Black populations initially declined (APC = -1.7, 1999–2003) but later increased significantly (APC = 3.0, 2014–2020). Hispanic/Latino populations declined (APC = -1.2, 1999–2009) before rising sharply (APC = 3.1, 2009–2020). American Indian or Alaska Native populations showed consistent increases (APC = 1.7, 1999–2020). Urban areas experienced initial declines (APC = -1.7, 1999–2004), followed by increases (APC = 2.4, 2011–2020). Non-metropolitan areas exhibited steeper increases (APC = 4.6, 2014–2020). Regionally, the West recorded the highest AAMR (24.0), followed by the Northeast (23.6), South (20.9), and Midwest (18.0). Mississippi had the highest state-level AAMR (36.3), while Wisconsin had the lowest (10.0). States in the top 90th percentile included Mississippi, Arkansas, and California, while Wisconsin, Minnesota, and Oregon were among the lowest. Conclusions: Cancer and RF mortality declined initially but have significantly increased in recent years. Disparities persist across gender, racial, and regional groups, underscoring the need for focused public health efforts and equitable resource distribution to address these trends.

e23101 Background: Liver cell carcinoma (LCC) and hepatic failure (HF) are major contributors to global adult mortality. Identifying trends and disparities in LCC and HF-related deaths is critical for addressing public health challenges and guiding prevention strategies. This study examines national trends in LCC and HF-related mortality from 1999 to 2023, with an emphasis on demographic, geographic, and temporal disparities in age-adjusted mortality rates (AAMRs). Methods: Using the CDC WONDER database (1999–2023), this descriptive study identified deaths attributed to LCC (ICD-10 code C22.0) and HF (ICD-10 code K72.9) among adults aged 25 and older. Mortality data were stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated, and trends were analyzed using Joinpoint regression to determine annual percent changes (APCs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05, and the study followed STROBE guidelines. Results: From 1999 to 2023, there were 22,963 deaths attributed to LCC and HF (Men: 17,822; Women: 5,141). Overall, AAMRs declined from 1999 to 2007 (APC: -2.4), stabilized between 2007 and 2017 (APC: 0.2), and declined again from 2017 to 2023 (APC: -3.5). Men experienced a steady AAMR decline from 1999 to 2010 (APC: -2.1), followed by stabilization (2010–2017, APC: 0.7), and further decline (2017–2023, APC: -4.4). Women showed a sharp AAMR decrease from 1999 to 2006 (APC: -3.8) and a relatively stable trend thereafter (APC: -0.1). Non-Hispanic Blacks people experienced an overall AAMR decline from 1999 to 2020 (APC: -0.9). Among Non-Hispanic Whites people, AAMRs decreased initially (1999–2006, APC: -2.6), rose slightly (2006–2018, APC: 0.5), and declined further (2018–2020, APC: -7.3). Regional AAMRs varied, with the West having the highest overall AAMR (5.6; 95% CI: 5.4–5.7) and the Midwest the lowest (3.2; 95% CI: 3.1–3.3). Hawaii reported the highest state AAMR (10.3; 95% CI: 8.9–11.6), while Arkansas had the lowest (2.4; 95% CI: 2.0–2.9). Urban-rural disparities revealed a sharper AAMR decline in metropolitan areas (1999–2005, APC: -3.9) and the non-metropolitan areas showed a slight increase (1999–2020, APC: 1.3). Conclusions: LCC and HF-related mortality rates have shown significant declines over the past two decades, with variations across gender, race, and geographic locations. Men and urban populations experienced steeper reductions in AAMRs, while rural populations exhibited slower improvements or slight increases in mortality. These findings highlight the need for targeted public health interventions to address disparities and further reduce LCC and HF-related mortality in vulnerable populations.

e16237 Background: Alcohol use (AU) and Liver cell carcinoma (LCC) are significant contributors to adult mortality worldwide. Examining trends and disparities in AU and LCC-related deaths is essential for understanding public health challenges and formulating targeted interventions. This study investigates national mortality patterns related to AU and LCC in the United States from 1999 to 2023, emphasizing demographic, geographic, and temporal disparities. Methods: This descriptive analysis used the CDC WONDER database (1999–2023) to identify AU-related deaths (ICD-10 codes E24.4, F10, G32.2, G62.1, G72.1, I42.6, K70, K85.2, K86.0, R78.0, T51, X65, Y15) and LCC (ICD-10 code C22.0) in adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated, stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Trends were analyzed using Joinpoint regression to compute annual percent changes (APCs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05, and analyses adhered to STROBE guidelines. Results: From 1999 to 2023, a total of 21,007 deaths were attributed to LCC and AU (Men: 18,836 Women: 2,171). AAMRs showed a stable trend from 1999 to 2003 (APC: 0.0; 95% CI: -8.7 to 4.9) but increased significantly from 2003 to 2019 (APC: 6.1; 95% CI: 5.7 to 7.4), stabilizing from 2019 to 2023 (APC: -0.6; 95% CI: -3.2 to 1.3). Men's AAMRs decreased from 1999 to 2003 (APC: -1.1; 95% CI: -10.4 to 3.4), then rose sharply from 2003 to 2019 (APC: 6.1; 95% CI: 5.6 to 7.1). For women, AAMRs increased significantly, particularly between 2013 and 2017 (APC: 12.4; 95% CI: -9.5 to 25.1). Non-Hispanic Black and White populations experienced notable increases in AAMRs, while Hispanic people showed an initial decline followed by an increase post-2004 (APC: 4.7; 95% CI: 3.7 to 7.9). The West had the highest regional AAMR (5.3; 95% CI: 5.2 to 5.5), while the Northeast recorded the lowest (2.1; 95% CI: 2.0 to 2.2). New Mexico had the highest state AAMR (8.4; 95% CI: 7.4 to 9.4), and Mississippi the lowest (1.2; 95% CI: 0.9 to 1.5). AAMRs rose more sharply in non-metropolitan areas from 1999-2020 (APC: 6.6; 95% CI: 5.9 to 7.8) compared to metropolitan regions from 2004 to 2020 (APC: 5.4; 95% CI: 4.9 to 6.5). Conclusions: AU and LCC-related mortality rates have increased significantly since 2003, with distinct gender, racial, and geographic disparities. Men and rural populations faced higher mortality increases, with notable variations across states and regions. These findings underscore the need for focused public health efforts to mitigate these disparities and address the growing burden of LCC and AU-related mortality.