Hafsa Shahid, MD1, Samreen Zafar, MD2, Aasiya Shahbaz Sakarwala, 3, Fatima Sial, MBBS4, Muhammad Usman, MBBS5, Rabia Shahid, MBBS6, Usman Bin Hameed, MD7, Ammad Javaid. Chaudhary, MD8, Syed-Mohammed Jafri, MD8 1Brigham and Women's Hospital, Boston, MA; 2Lake Huron Medical Center, Port Huron, MI; 3Dow Medical College, Karachi, Sindh, Pakistan; 4King Edward Medical University, Lahore, Punjab, Pakistan; 5Ziauddin University, Detroit, MI; 6Faisalabad Medical University, Pakistan, Lahore, Punjab, Pakistan; 7Corewell Health William Beaumont University Hospital, Royal Oak, MI; 8Henry Ford Health, Detroit, MI Introduction: Intestinal diverticular disease is generally benign but can cause severe complications leading to mortality. This study analyzes national mortality trends and demographic disparities related to diverticular disease in the U.S. from 1999 to 2020. Methods: A retrospective analysis of CDC WONDER mortality data (1999–2020) was conducted. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Trends were assessed using Annual Percent Change (APC), stratified by age, sex, race/ethnicity, region, and urbanization status. Results: From 1999 to 2020, 115,009 deaths were attributed to diverticular disease. The overall AAMR was 2.413 (95% CI: 2.399–2.427), declining from 3.634 (95% CI: 3.545–3.723) in 1999 to 1.935 (95% CI: 1.882–1.988) in 2020. Mortality rates decreased steadily from 1999 to 2018 (APC ranging from -2.51 to -5.21), followed by a rise from 2018 to 2020 (APC: 3.12). Age-stratified data showed the highest mortality among those aged 85+, followed by 75–84 and 65–74 years. The 85+ group had a significant decline in mortality from 1999 to 2014 (APC: -5.13), with no significant change after 2014. Middle-aged adults (55–64 years) experienced a mortality decline until 2015 (APC: -2.56), then a significant increase (APC: 4.42). Younger adults (35–44 years) showed a slight, non-significant increase, while the 45–54 age group had a small but significant decline. Females exhibited higher mortality (AAMR: 2.63) compared to males (AAMR: 2.061). Among racial/ethnic groups, non-Hispanic (NH) Whites had the highest mortality (AAMR: 2.507), followed by NH Black or African Americans (2.098), Hispanics or Latinos (1.715), American Indians or Alaska Natives (1.45), and NH Asians or Pacific Islanders (0.813). Geographically, the Midwest and West regions reported the highest mortality rates (AAMR: 2.6 for both), followed by the South and Northeast (AAMR: 2.3 each). Mortality was higher in non-metropolitan areas ( AAMR: 2.9) compared to metropolitan areas (AAMR: 2.3). At the state level, West Virginia ranked in the 90th percentile for mortality, whereas Hawaii was in the 10th percentile. Discussion: Diverticular disease-related mortality in the U.S. has significantly declined from 1999 to 2018 but showed a recent increase through 2020. Marked disparities exist by age, sex, race/ethnicity, and region. These findings emphasize the need for targeted public health strategies to address disparities and improve outcomes, especially in underserved populations.
Figure: Figure 1. Age, sex, race, geographic, and urbanization-stratified trends in diverticular disease mortality in the U.S. (1999–2020) reveal significant disparities despite overall declining rates
Disclosures: Hafsa Shahid indicated no relevant financial relationships. Samreen Zafar indicated no relevant financial relationships. Aasiya Shahbaz Sakarwala indicated no relevant financial relationships. Fatima Sial indicated no relevant financial relationships. Muhammad Usman indicated no relevant financial relationships. Rabia Shahid indicated no relevant financial relationships. Usman Bin Hameed indicated no relevant financial relationships. Ammad Chaudhary indicated no relevant financial relationships. Syed-Mohammed Jafri: Abbvie – Speakers Bureau. Gilead – Speakers Bureau. Intercept – Speakers Bureau. Ironwood – Speakers Bureau. Takeda – Speakers Bureau.
Hafsa Shahid, MD1, Samreen Zafar, MD2, Aasiya Shahbaz Sakarwala, 3, Fatima Sial, MBBS4, Muhammad Usman, MBBS5, Rabia Shahid, MBBS6, Usman Bin Hameed, MD7, Ammad Javaid. Chaudhary, MD8, Syed-Mohammed Jafri, MD8. P4533 - Mortality Trends in Diverticular Intestinal Disease in the United States: A Population-Based CDC Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
