Digestive Cancer Mortality in the U.S.: Recent Trends and the Influence of COVID-19

Background A comprehensive analysis of the trends in mortality of digestive cancers over the past decades in the U.S. is lacking. This study investigates U.S. mortality trends for digestive cancers during the pandemic and assesses the impact of COVID-19. Methods Using data from the National Vital Statistics System and CDC WONDER (2006–2023), age-standardized all-cause mortality (ASACM) rates for digestive cancers were analyzed by joinpoint analysis with annual percentage changes (APC). The percentage of COVID-19-related deaths and the proportion of COVID-19-related deaths among the predicted excess mortality were calculated. Results Between 2018 and 2023, there were 1,089,603 digestive cancer deaths in U.S. adults. The ASACM for digestive cancer decreased significantly from 2006 to 2018 (APC, -0.81%, 95%CI: -1.37, -0.64%), then plateaued from 2018 to 2023 (APC, 0.25%, 95%CI: -0.40\(\:,1\).84). The ASACM was stable at approximately 71 per 100,000 persons between 2018 and 2020, increased to 72.5 per 100,000 persons in 2021, and then declined back to baseline in 2022. The percentage of COVID-19-related deaths among decedents with digestive cancer rose between 2020 and 2022 (1.6%->2.0%->2.2%) and then declined in 2023 (0.8%). The proportion of COVID-19-related deaths was higher in men, older individuals, and American Indian/Alaska Native populations. Conclusions The COVID-19 pandemic temporarily reversed the decreasing trend of digestive cancer mortality. The impact of COVID-19 on cancer-related mortality is underestimated by the proportion of COVID-related deaths, likely related to indirect effects from delays in screening and treatment.