588 Background: Biliary tract carcinomas (BTC) affect about 8,000 people annually across the U.S. and present with dismal prognoses. Disparities in mortality trends across the last two decades are not well-characterized. Methods: A retrospective analysis of death certificate data from the CDC WONDER database was performed for adults ≥25 years from 1999 to 2023 (ICD-10 codes C23, C24.0, C24.1, C24.9). Age-adjusted mortality rates (AAMRs) per 100,000 were standardized to the 2000 U.S. population. Data was stratified by age groups, race, gender, and census regions. Trends were evaluated using Joinpoint. Results: From 1999 to 2023, 103,589 deaths resulted from BTC. Overall AAMR declined from 2.18 in 1999 to 1.85 in 2023 (AAPC: -0.858, 95% CI: -1.139 to -0.576), decreasing significantly from 1999 to 2008 (APC-2.507) with a non-significant rise from 2008 onwards. Women consistently exhibited higher AAMRs (AAMR:1.958, AAPC: -0.931) than men (AAMR:1.745, AAPC: -0.763). 65+ years individuals exhibited highest death rates (AAMR: 7.382 , AAPC:-1.176). American Indians had the highest AAMR (2.295) but a significant decline (AAPC: -3.829) compared to Hispanic (AAMR: 2.448) and Black individuals (AAMR: 2.144). Metropolitan areas had higher AAMR (1.84) than non-metropolitan areas (1.81). Conclusions: The steady rise in BTC-related mortality from 2008 onwards with persistent demographic and temporal disparities underscores the need for timely and targeted interventions. Deaths and AAMRs per 100,000 for mortality trends related to BTC in adults in the U.S. between 1999 and 2023. Variable Deaths (n) AAMR (95% CI) Overall 103,589 1.852 (2.18-1.85) Male 41,713 1.745 (1.96-1.74) Female 61,876 1.958 (2.37-1.93) Non-Hispanic American Indian 840 2.295 (4.15-0.9) Non-Hispanic Asian 4,600 2.042 (2.59-1.84) Non-Hispanic Black 11,727 2.144 (2.2-2.19) Non-Hispanic White 86,344 1.811 (2.17-1.79) Hispanic 10,823 2.448 (3.32-2.19)
Shahriar et al. (2026) studied this question.