Trends and disparities in lung cancer– and cardiovascular disease–related mortality among older adults in the United States: A CDC-WONDER analysis.

Abstract

e22535 Background: Lung Cancer remains the leading cause of cancer-related death both in the U.S. and worldwide. Current evidence suggests that lung cancer patients with cardiovascular comorbidities tend to have lower survival rates in contrast to those without. In this study, we aim to explore the mortality effects of lung cancer complicated by cardiovascular diseases by examining trends and disparities across different sociodemographic strata. Methods: Deidentified death certificate data from the CDC WONDER database were analyzed for lung cancer and cardiovascular disease-related mortality among adults aged ≥65 years (older adults). Age-adjusted mortality rates (AAMR) per 100,000 persons and average annual percent change (AAPC) were calculated and stratified by year, gender, state, urban-rural status, census region, place of death (POD), and age group. Results: From 1999 to 2020, 733,906 deaths were attributed to lung cancer with co-morbid cardiovascular diseases in older adults. The majority of these deaths occurred in Medical Facilities (39.4%), while death at the decedent’s house followed at second (34.5%). Overall, AAMRs decreased from 92.7 in 1999 to 69.9 in 2020 (AAPC: -1.35 95% CI: -1.40 to -1.26). Males had higher mortality rates than females throughout the study period (AAMR: 139.9 vs. 61.9, respectively). Furthermore, Non-Hispanic Blacks or African Americans had the highest overall mortality rates (AAMR: 86.7), followed very closely by non-Hispanic whites (AAMR: 81.1); in contrast, Hispanics exhibited the lowest (AAMR: 43.1) among all racial/ethnic groups. AAMRs also varied significantly across U.S. census regions, with the highest mortality rates observed in the Northeastern region (AAMR: 90.6). Lastly, non-metropolitan areas had higher mortality rates than metropolitan areas (AAMR: 89.0 vs 78.5, respectively). Conclusions: Mortality rates in older lung cancer patients with co-morbid cardiovascular diseases decreased from 1999 to 2020. Higher mortality rates were observed in men, non-Hispanic African Americans, and individuals residing in non-metropolitan areas and the northeastern U.S., indicating the need for targeted public health efforts in these high-risk groups.