Naqvi, Syeda Malika

e17594 Background: Cardiovascular disease (CVD) is the leading cause of death among women with ovarian cancer. This study investigates cardiovascular mortality in women with ovarian cancer across the United States, assessing trends by geography and urbanization. Methods: Mortality data from the CDC WONDER database (1999–2020) were analyzed. Females with ovarian cancer listed on the death certificate and cardiovascular disease as the cause of death were identified using ICD-10 codes. Age-adjusted mortality rates (per 100,000) were calculated and stratified by census region and urbanization. Trends were evaluated using Average Annual Percent Change (AAPC) calculated by the Joinpoint Regression Program V5.4.0. Results: From 1999 to 2018, cardiovascular mortality in ovarian cancer patients declined, with an APC of –2.09%, consistent across regions and urbanization levels. However, from 2018 to 2020, a concerning reversal occurred, with mortality increasing by +3.79% per year. The abrupt rise in mortality is observed in the Midwest region, with an APC of +3.99, and in small and medium metro regions, with APCs of +7.38 and +6.46, respectively. This reversal in cardiovascular mortality in ovarian cancer from 2018 to 2020 is likely due to the COVID-19 pandemic that disrupted screening and treatment. Conclusions: This 21-year analysis demonstrates a long-term decline in cardiovascular mortality among women with ovarian cancer, followed by a sharp reversal from 2018 to 2020. This increase suggests the urgent need for public health interventions to reduce cardiovascular risk among ovarian cancer patients.

e17524 Background: Cervical cancer remains one of the leading causes of female cancer mortality, while heart failure drives chronic disease burden. Their coexistence complicates outcomes through shared risk factors, cardiotoxicity, and mortality. This study examined cervical cancer mortality trends in patients with heart failure, assessed disparities, and aimed to inform integrated management strategies. Methods: We analyzed death certificates from CDC WONDER Database (1999–2020), using ICD-10 C53 (cervical cancer) and I50 (heart failure). Female mortality was stratified by race and urbanization. Joinpoint Regression Program V5.4.0 calculated Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Results: A total of 5,534 deaths were identified. Age-adjusted mortality rates (AAMR) declined overall, but trends varied. Among females, mortality fell from 0.1102 per 100,000 in 1999 to 0.076 in 2020 (AAPC -1.28%). Three phases emerged: a modest decline (1999-2006, APC -1.45%), a rapid decline (2006-2009, APC -17.6%), and a concerning reversal (2009-2020, APC +3.27%). The latter increase may reflect reduced screening, declining vaccination rates, or COVID-19 disruptions.By urbanization, large central metropolitan areas showed a steady decline (APC -4.13%). By race, White women demonstrated a consistent reduction (APC -2.61%), indicating sustained benefits of screening and vaccination. Conclusions: Cervical cancer mortality in heart failure patients declined from 1999-2020, reflecting prevention and healthcare advances. However, disparities persist, with notable increases among women since 2009. These findings highlight successes but stress the urgent need for vaccination and screening.

e16229 Background: Liver cancer is a leading cause of cancer-related mortality worldwide, with rising incidence linked to metabolic disorders. Conditions such as obesity, diabetes mellitus, and metabolic syndrome contribute substantially to non-viral liver carcinogenesis. However, long-term temporal trends and mortality disparities among adults with metabolic disorders in the United States remain incompletely characterized. Methods: Mortality data for liver cancer among adults with metabolic disorders were obtained from the centers for disease control and prevention (CDC) mortality database. Adults aged 25 years and older were included and age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Temporal trends were evaluated using joinpoint regression and average annual percent change (AAPC) with 95% confidence intervals. Results: From 1999–2023, AAMR for liver cancer in adults with metabolic disorders rose from 0.17 to 0.65 per 100,000 in the U.S., with an overall AAPC of 5.95% [95% CI 5.2–6.7]. Men had higher absolute mortality (0.25→0.93; AAPC 5.68%), while women showed a sharper recent rise (0.11→0.41; AAPC 7.08%), peaking at 11.86% annually after 2016. Hispanic/Latino (0.27→0.89; AAPC 6.73%) and Black populations (0.15→0.75; AAPC 6.15%) experienced steady increases, whereas White mortality accelerated post-2011 (AAPC 9.37%). Regionally, the West had highest rates, the South showed highest growth, and Northeast/Midwest had sharp recent increases. Rural mortality overtook urban by 2020 (0.50 vs. 0.48). Most deaths occurred in medical facilities (48.2%) or home (33.1%), with highest state rates in Hawaii (0.56), Texas (0.47), and Rhode Island (0.47). Conclusions: Mortality from liver cancer in adults with metabolic disorders rose sharply in the U.S. since 1999, with accelerating trends and marked disparities by sex, race/ethnicity, region, and urbanization. These findings highlight an urgent need for targeted metabolic risk reduction and equity-focused prevention strategies. Trends in Age-Adjusted Mortality Rates (AAMR) from 1999 to 2023 by demographic and geographic variables. Variable AAMR 1999 (per 100,000) AAMR 2023 (per 100,000) AAPC (95% CI) Overall 0.16 0.64 5.94* (5.22 – 6.67) Males 0.25 0.92 5.67* (4.82 – 6.5) Females 0.11 0.40 7.08* (5.79 – 8.38) White 0.16 0.63 6.12* (5.41 – 6.82) Black 0.15 0.75 6.15* (5.11 – 7.19) Hispanic or Latino 0.27 0.89 6.73* (5.98 – 7.48) Variable AAMR 1999 (per 100,000) AAMR 2020 (per 100,000) AAPC (95% CI) Urban 0.16 0.47 5.38* (4.43 – 6.33) Rural 0.19 0.50 5.73* (4.48 – 6.99) AAPC denotes the average annual percent change; * indicates p < 0.05.

e16067 Background: Gastric carcinoma remains a significant cause of cancer mortality in the United States. Although overall mortality rates have declined, persistent disparities exist across racial, age, and geographic groups. For cancer patients, sepsis—a life-threatening infection response—is a major fatal complication. Analyzing linked mortality data is crucial for identifying high-risk populations, understanding the burden of cancer-associated infections, and guiding targeted prevention and treatment strategies to improve outcomes and achieve health. Methods: This cross-sectional study used CDC WONDER mortality data from 1999–2020 for adults aged 25 years and older. Causes of death were identified using ICD-10 codes, and age-adjusted mortality rates (AAMRs) were calculated across sex, race/ethnicity, age, census regions, and urban–rural categories. Mortality trends were assessed using Joinpoint regression to estimate average annual percentage changes (AAPC) with 95% confidence intervals (CIs) and statistical significance. Results: From 1999 to 2020, U.S. stomach cancer mortality declined overall, with AAMRs decreasing from 0.29 to 0.22 per 100,000 (AAPC = –0.8%, 95% CI: –1.64 to 0.04). Significant declines occurred among adults aged 65–74 (APC = –1.7%, 95% CI: –2.32 to –1.05), 75–84 (APC = –1.9%, 95% CI: –2.65 to –1.05), and ≥85 years (APC = –3.0%, 95% CI: –4.02 to –1.99). Adults 45–54 years experienced increasing mortality after 2005 (APC = 5.1%, 95% CI: 2.82 to 7.46), while rates among 55–64 years remained stable. Male mortality declined significantly (AAPC = –1.24%, 95% CI: –1.93 to –0.54), whereas female mortality showed no significant long term change (AAPC = –0.93%, 95% CI: –2.44 to 0.60). Black (AAPC = –2.25%, 95% CI: –3.02 to –1.47) and Hispanic/Latino populations (AAPC = –1.50%, 95% CI: –2.26 to –0.74) experienced significant declines. Regionally, the Northeast showed the largest decline (AAPC = –2.30%, 95% CI: –3.52 to –1.07), while the Midwest, South, and West demonstrated no significant long term trends. Metropolitan areas declined from 1999–2011 (APC = –2.80%, 95% CI: –4.44 to –1.14). Conclusions: While overall U.S. gastric cancer mortality declined from 1999–2020, this progress is uneven. Significant increases among adults aged 45–54 and stable rates for those 55–64 highlight an emerging concern. Furthermore, declining trends are concentrated in specific demographic groups and regions, such as the Northeast, revealing persistent disparities. These findings underscore the need for targeted prevention and research focused on younger adults and lagging geographic areas.