Trends in lung cancer epidemiology and mortality over 12 years: Socioeconomic and demographic disparities.

Abstract

8042 Background: Lung cancer (LC), the most common cancer worldwide, remains a significant health burden with high rate of incidence and mortality in the United States and worldwide. Studies show that Black patients are 15% less likely to obtain an early diagnosis and have lower 5-year survival compared to White patients. Methods: The National Inpatient Sample database (2010–2021) was analyzed to identify adult hospitalizations with LC as a primary or secondary diagnosis. Multivariate logistic regression assessed epidemiologic and mortality trends and their association with demographic factors. Results: A total of 1,462,998 hospitalizations were identified with LC between 2020 and 2021. Of these, 196,225 patients (13.4%, 95% CI: 13.2–13.6) received palliative care. For metastatic LC admissions (n = 574,935), 21.5% (123,577) received palliative treatment. In 2010, the mean patient age was 67.6 years, which went up to 69.1 years in 2021. The percentage of LC patients with age over 65 years increased from 62.7% to 68.3%, whereas for patients under 45 and those between 45 and 65 years old, the percentage decreased from 2.0% to 1.4%, and 35.3% to 30.3%, respectively. The percentage of women diagnosed with lung cancer increased from 47.1% to 52.3% in 12 years. From 2010-2021, overall mortality from LC decreased (OR 0.96, 95% CI: 0.95–0.96). However, mortality was found to be lower in females (OR 0.80, 95% CI: 0.78–0.82, p < 0.001), and higher in Blacks than Whites (OR 1.07, 95% CI: 1.02–1.17, p = 0.003), and higher in those over 65 than in those between the ages of 18 and 45 (OR 1.11, 95% CI: 0.99–1.24, p = 0.063). Mortality rates were greater among Black people across all genders. While age-related differences were not significant among females, older age was linked to higher mortality among males (OR 1.15, 95% CI: 0.99–1.34, p = 0.066). Across all ethnicities, the death rate was consistently lower for females. Only White people showed substantial variations in age-related mortality, with older patients having higher mortality. Mortality rates within the lowest income bracket were the same for any age and ethnic group. Conversely, Black people had a higher mortality rate than White people in the highest income category (OR 1.24, 95% CI: 1.08–1.41, p = 0.002). Conclusions: Over the years, while LC mortality has decreased overall, disparities persisted with Black patients showing higher mortality compared to Whites, even in the higher income brackets. Increased mortality was associated with older age and male gender. These findings highlight the need for targeted interventions to address racial, gender, and socioeconomic disparities and to improve the survival of the identified high-risk population, especially minorities.