Dr Roof on Disparities in Lung Cancer Mortality Rates in the United States

Logan Roof, MD, chief fellow, Cleveland Clinic, discusses findings from a study investigating trends in lung cancer mortality across different sociodemographic populations and locations in the United States between 1999 and 2020.

This study used the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research Database to assess lung cancer mortality information and calculate lung cancer age-adjusted mortality rates per 100,000 people. Investigators found that each year between 1999 and 2020, lung cancer mortality in the United States decreased at a rate of 2.6%.

When investigators assessed mortality rates by gender, they found that in 1999, men had a higher age-adjusted mortality rate than women, at 76.8 vs 40.2, respectively. However, in 2020, the rate of lung cancer mortality had decreased in men, who had an age-adjusted mortality rate of 38.1 compared with 26.9 in women.

Additionally, different geographic regions across the United States had different rates of declining lung cancer mortality, Roof says. For instance, regions in the West appeared to have more rapid declines in lung cancer mortality compared with regions in the Midwest, Roof explains. In 1999, location-based age-adjusted mortality rates ranged from 26.4 to 74. In 2020, they ranged from 15.1 to 50.3. Rural populations had the highest age-adjusted mortality rates in the United States, as well as the least rapid rates of mortality decline. Arkansas and Kentucky were among states in the 90th percentile for mortality, and Hawaii and Utah were among states in the 10th percentile for mortality.

Furthermore, investigators found disparities in lung cancer mortality rates between populations of different races and ethnicities, Roof notes. Non-Hispanic White people had the highest mortality decrease of any observed subgroup, with an annual mortality decrease of 2.5% and age-adjusted mortality rates of 57.2 in 1999 vs 34.9 in 2020.

In total, the populations experiencing the highest age-adjusted mortality rates from 1999 to 2020 were men, non-Hispanic Black people, people in rural areas, and people in southern states. These findings indicate subgroups of people in the United States who may benefit from targeted interventions to decrease lung cancer mortality, Roof concludes.