Demographic Trends Related to Stomach Cancer and Diabetes in The United States, 1999-2023: A CDC Wonder Study

Background: Stomach cancer and diabetes mellitus contribute majorly to morbidity and mortality, imposing clinical and economic burden in the United States. Although diabetes has been proposed as a potential risk factor for gastric cancer, population-level mortality trends involving both conditions remain incompletely understood. Objective: This study aimed to evaluate long-term mortality trends associated with co-existing unspecified malignant neoplasms of the stomach and unspecified diabetes mellitus without complications in the United States from 1999 to 2023. Methods: Mortality data were obtained from the CDC WONDER database using ICD-10 codes C16.9 and E14.9. Age-adjusted mortality rates (AAMRs) were calculated and analyzed using Joinpoint regression software to assess annual percent change (APC) overall and stratified by sex and U.S. census region. Statistical significance was defined as p ≤ 0.05. Results: Overall AAMRs declined significantly from 1999 to 2017, with a pronounced decrease between 2012 and 2017, followed by stabilization with a slight upward trend in recent years. Mortality rates were consistently higher in males than in females; however, females demonstrated a sustained and significant decline throughout the study period. Regional analyses revealed persistent geographic disparities, with initially higher mortality in the West that declined substantially over time, while the South exhibited higher rates in more recent years. Conclusion: Mortality associated with co-existing stomach cancer and diabetes mellitus has decreased distinctly in the United States over the past two decades, likely reflecting improvements in early detection, treatment, and risk factor management.