Work

Lung cancer mortality with co-reported chronic lower respiratory disease among older US adults: A serial cross-sectional secondary analysis of the CDC WONDER multiple cause of death database, 1999–2024

Year: 2026

Type: article

Abstract: Reduced respiratory reserve can also narrow treatment options and is associated with clinically distinct patterns of comorbidity and survival 3 .National mortality studies have begun to characterize this overlap.Grobman et al. 4 evaluated lung cancer deaths among people with CLRD through 2020 and identified persistent demographic and rural disparities.More recently, Faheem et al. 5 examined lung cancer and chronic obstructive pulmonary disease among adults aged ≥65 years through 2024, defining either condition in underlying or contributing cause ABSTRACT INTRODUCTION Lung cancer mortality has declined in the United States, but progress may be slower among older adults with chronic lower respiratory diseases (CLRD).The aim of this study was to characterize mortality trends and the contribution of co-reported CLRD among older adults whose underlying cause of death was lung cancer. METHODSWe conducted a serial cross-sectional secondary analysis of CDC WONDER Multiple Cause of Death data for US adults aged ≥65 years, from 1999 through 2024.Lung cancer was defined by underlying cause code C34 and CLRD by contributing cause codes J40-J47.Temporal trends were evaluated using joinpoint regression, and the phenotype's contribution to all lung cancer deaths was quantified. RESULTSThe analysis identified 490902 deaths.The age-adjusted mortality rate declined from 49.73 to 35.76 per 100000, with an average annual percent change (AAPC) of -1.34% (95% confidence interval, CI: -1.45 --1.22).Annual deaths increased from 17287 to 20963, while the phenotype share of all lung cancer deaths increased from 15.95% to 20.54%.Overall lung cancer mortality declined more rapidly (AAPC= -2.30%; 95% CI: -2.40 --2.19).Declines were slower among females (AAPC= -0.50%), Midwest residents (-0.94%),South residents (-0.83%), and non-metropolitan populations through 2020 (-0.27%).No significant long-term change occurred among non-Hispanic American Indian or Alaska Native adults (AAPC=0.53%;95% CI: -0.45-1.90)or adults aged ≥85 years (AAPC=0.33%;95% CI: -0.01-0.78).CONCLUSIONS Declining age-adjusted mortality coexisted with increasing annual deaths and a growing proportional contribution of co-reported CLRD to lung cancer mortality.Linked clinical studies may help clarify the contributions of pulmonary impairment, smoking history, stage, treatment, and access to care.

Source: Pneumon

DOI: 10.18332/pne/240437