819 Background: Gastrointestinal (GI) cancers remain a significant public health concern in the United States, with notable regional disparities in mortality outcomes. Understanding the geographic distribution of GI cancer mortality may inform targeted public health interventions and resource allocation. This study evaluates the regional mortality burden of six major GI malignancies—stomach, gallbladder, pancreas, biliary tract, colon, and esophageal—among individuals aged ≥25-74 years using data from the Centers for Disease Control and Prevention (CDC). Methods: A total of 764,105 gastrointestinal (GI) cancer deaths across the four U.S. census regions (South, Midwest, West, and Northeast) were analyzed to assess regional differences in mortality for stomach, gallbladder, pancreas, biliary tract, colon, and esophageal cancers. Mortality data was stratified by region, and one-way analysis of variance (ANOVA) was employed to assess differences in death counts among regions. To ensure statistical rigor and control for Type I error in multiple comparisons, the Delta method with a 1% significance threshold (Δ = 0.01) was applied. Post hoc analyses were conducted to confirm regional differences. Results: A total of 764,105 GI cancer deaths were recorded across four U.S. census regions: South, Midwest, West, and Northeast. The South exhibited the highest mortality across all cancer types. One-way ANOVA followed by post hoc comparisons demonstrated that the Southern region exhibited significantly higher mortality than all other regions, with p < 0.05 and delta 1%. Pancreatic cancer accounted for the greatest number of deaths nationwide, with the South reporting 106,916 deaths, followed by the Midwest (64,132), West (59,509), and Northeast (52,698). Colon cancer (99,560) followed by stomach cancer (25,485) and esophageal cancer (34,577) mortality was also found to be highest in the Southern region. Gallbladder and biliary tract cancer deaths followed similar patterns, with the South consistently reporting the highest counts. Conclusions: Marked regional disparities exist in the U.S. when it comes to GI cancer mortality, with the Southern region bearing a disproportionate burden. These findings underscore the need for region-specific cancer control strategies, including improved screening, early detection, and equitable access to treatment. Further investigation into socioeconomic, behavioral, and healthcare access factors contributing to these disparities is warranted. Regional inequities in gastrointestinal cancer mortality. Cancer Type Northeast Midwest South West Esophageal 10726 24057 34577 18946 Stomach 11976 12047 25485 16573 Gallbladder 2507 2829 4527 3083 Pancreatic 52698 64132 106916 59509 Biliary Tree 2200 2615 4846 2623 Colon 39917 53384 99560 50422
Gill et al. (Sat,) studied this question.