Projected burden of lung cancer and pneumonia among older adults in the United States: A CDC WONDER forecasting analysis, 1999–2035.

Abstract

e23066 Background: Lung cancer and pneumonia commonly coexist and contribute substantially to mortality in older adults. Evaluating long-term mortality trends for both conditions is essential to assess the impact and limitations of health interventions. This study examined mortality trends due to lung cancer and pneumonia among U.S. adults aged ≥65 years by demographic and geographic factors. Methods: We retrospectively analyzed CDC WONDER mortality data from 1999–2024 for individuals aged ≥65 years. Lung cancer and pneumonia deaths were identified using ICD-10 codes C34 and J18. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Temporal trends were assessed using Joinpoint regression to estimate annual percent changes with 95% confidence intervals, and future mortality was projected using an optimized ARIMA model. Results: From 1999–2024, 161,596 deaths were attributed to lung cancer and pneumonia. AAMRs were highest in Kentucky (19.4) and lowest in Utah (4.7). Overall AAMRs declined from 22.2 in 1999 to 10.3 in 2024, with projected reductions from 9.82 in 2025 to 5.06 in 2035 (AAPC −3.09; 95% CI −3.58 to −2.61; p<0.001). Mortality declined in both sexes but remained higher in males. In 2024, AAMRs were highest among non-Hispanic Black individuals and in the South, followed by the Midwest. Nonmetropolitan areas had higher AAMRs than metropolitan regions. Conclusions: Although mortality declined overall, disparities persist, particularly among males, non-Hispanic Black populations, rural residents, and those in the South and Midwest. Targeted strategies addressing healthcare access and comorbidity burden remain essential. Characteristic Number of Deaths (N) Age-Adjusted Mortality Rate (per 100,000):1999 Age-Adjusted Mortality Rate (per 100,000):2024 Average Annual Percent Change (AAPC) (1999–2024) with 95% CI Overall 161,596 22.2 10.3 -3.02 (-3.64 to -2.40) Sex Female 64,290 13.4 8.1 -1.85 (-2.67 to -1.01) Male 97,306 35.8 13.4 -3.76 (-4.79 to -2.71) Race and Ethnicity White 138,440 22 10.9 -2.65 (-3.53 to -1.77) Black or African American 15,634 23.9 11 -3.14 (-4.76 to -1.49) Hispanic or Latino 6,182 13.9 6.6 -2.71 (-3.63 to -1.78) Census Region West 31,065 22.8 8.5 -3.50 (-4.76 to -2.22) South 62,970 23.2 11.6 -2.74 (-4.00 to -1.46) Northeast 30,673 20.5 10 -2.72 (-3.50 to -1.93) Midwest 36,888 21.7 10.5 -2.89 (-3.98 to -1.79) Urbanization (1999–2020) Age-Adjusted Mortality Rate (per 100,000): 1999 Age-Adjusted Mortality Rate (per 100,000): 2020 Metropolitan 107,681 21.5 10.5 -3.66 (-4.55 to -2.77) Non-metropolitan 29,876 25.1 12.8 -3.37 (-4.22 to -2.51) Age Group Crude Mortality Rates per 100,000: 1999 Crude Mortality Rates per 100,000: 2024 65–74 years 69,679 17.9 7.8 -3.40 (-4.66 to -2.12) 75–84 years 66,721 27.3 13 -2.71 (-3.96 to -1.45) 85+ years 25,196 25.5 13.5 -2.63 (-3.50 to -1.75)