Lung cancer mortality trends and disparities: A cross-sectional analysis 1999–2020

• Published in: Cancer epidemiology Vol. 92; p. 102652
• Main Authors: Soin, Sabrina, Ibrahim, Ramzi, Wig, Rebecca, Mahmood, Numaan, Pham, Hoang Nhat, Sainbayar, Enkhtsogt, Ferreira, João Paulo, Kim, Roger Y., Low, See-Wei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-10-2024; Elsevier Limited
• Subjects: Age; Black lung; Cross-sectional studies; Demography; Disparities; Epidemiology; Ethnicity; Females; Gender; Lung cancer; Metropolitan areas; Morbidity; Mortality; Native North Americans; Pacific Islander people; Population; Regression analysis; Rural areas; Socioeconomic factors; Software; Trends; Vital statistics; United States > US; Alaska; Disparities; Epidemiology; Lung cancer; Mortality
• DOI: 10.1016/j.canep.2024.102652
• EISSN: 1877-783X
• ISSN: 1877-7821; 1877-783X

Lung cancer remains a leading cause of morbidity and mortality in the United States. Given the importance of epidemiological insight on lung cancer outcomes as the foundation for targeted interventions, we aimed to examine lung cancer death trends in the United States in the recent 22-year period, exploring demographic disparities and yearly mortality shifts.
Mortality information was obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database from the years 1999–2020. Demographic information included age, sex, race or ethnicity, and area of residence. We performed log-linear regression models to assess temporal mortality shifts and calculated average annual percentage change (AAPC) and compared age-adjusted mortality rates (AAMR) across demographic subpopulations.
A total of 3,380,830 lung cancer deaths were identified. The AAMR decreased from 55.4 in 1999-31.8 in 2020 (p<0.001). Males (AAMR 57.6) and non-Hispanic (NH) (AAMR 47.5) populations were disproportionately impacted compared to females (AAMR 36.0) and Hispanic (AAMR 19.1) populations, respectively. NH Black populations had the highest AAMR (48.5) despite an overall reduction in lung cancer deaths (AAPC −3.3 %) over the study period. Although non-metropolitan regions were affected by higher mortality rates, the annual decrease in mortality among metropolitan regions (AAPC −2.8 %, p<0.001) was greater compared to non-metropolitan regions (AAPC −1.7 %, p<0.001). Individuals living in the Western US (AAPC −3.4 %, p<0.001) experienced the greatest decline in lung cancer mortality compared to other US census regions.
Our findings revealed lung cancer mortality inequalities in the US. By contextualizing these mortality shifts, we provide a larger framework of data-driven initiatives for societal and health policy changes for improving access to care, minimizing healthcare inequalities, and improving outcomes.
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•From 1999 to 2020, there has been a decline in lung cancer mortality rates.•The reduction in lung cancer mortality rates was more pronounced in metropolitan areas during the same period.•Males and non-Hispanic groups experienced higher age-adjusted lung cancer mortality rates than their female and Hispanic counterparts.•These findings highlight the critical need for public health interventions to address and mitigate lung cancer mortality disparities.