Disparities in Lung Cancer Death Among People with Chronic Lower Respiratory Diseases in the United States

PurposePatients with chronic lower respiratory diseases (CLRD) are at a higher risk of lung cancer. Less is known regarding how the risk of CLRD-associated lung cancer death might have changed on a national scale over the past 20 years across demographic and regional groups.MethodsWe calculated age-adjusted mortality rates (AAMR) for lung cancer death among people with CLRD using 1999-2020 data from the CDC WONDER multiple cause of death database. Rates were compared between demographic groups and time periods.ResultsRates of lung cancer death among people with CLRD were highest among White Americans compared to other racial groups. Elevated rates of lung cancer death were seen among men (AAMR = 25.054, 95% CI: 24.960-25.148) and those aged 65 + (AAMR = 44.776, 95% CI: 44.638-44.913) compared to their counterparts. Rates were higher in the Midwest (AAMR ratio = 1.410, 95% CI: 1.401-1.418) and the South (AAMR ratio = 1.290, 95% CI: 1.282-1.298) compared to the Northeast. Rates were elevated in rural areas (AAMR ratio = 1.444, 95% CI: 1.438-1.451). Between 1999 and 2004 and 2016-2020, the AAMR of CLRD-associated lung cancer death decreased from 21.647 (95% CI: 21.528-21.765) to 17.221 (95% CI: 17.123 - 17.318). Rates decreased over time across demographic groups.ConclusionCLRD-associated lung cancer deaths significantly decreased in the United States between 1999 and 2020. Despite this progress, White people, men, older adults (65 +), and people in rural areas continue to experience higher CLRD-associated lung cancer mortality rates than their counterparts.