Abstract
Gastric cancer (GC) remains a global health concern. In the United States, incidence and mortality have declined, but disparities across populations persist. Monitoring trends is vital for targeted prevention and early detection. We analyzed GC mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) for 1999-2023. Analyses were stratified by sex, age, race, 2013 census region, and urbanization level. We calculated percentage changes in deaths and used Joinpoint regression to assess trends in age-adjusted mortality rates (AAMRs). Mortality patterns were compared across demographic and geographic subgroups. From 1999 to 2023, 286,308 GC deaths were recorded in the United States. While overall deaths and AAMRs declined, increases in deaths were observed among Hispanic individuals, those aged 55 to 64, and residents of the Western region. Nevertheless, AAMRs declined significantly across all subgroups. AAMR was consistently higher in men than women. Non-Hispanic White individuals had the lowest AAMRs among racial groups. The Midwest had the lowest regional AAMRs, and metropolitan areas had lower AAMRs than non-metropolitan areas. AAMRs increased markedly with age. GC mortality in the United States declined from 1999 to 2023, reflecting advances in prevention and treatment. However, rising deaths in Hispanic individuals, middle-aged adults, and Western residents reveal ongoing disparities. Targeted efforts are needed to close these gaps and ensure health equity.