ASPO Abstracts
Disparities in lung cancer mortality by sex, race, ethnicity, and rural-urban status
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Our objectives were to describe recent age-adjusted death rates for lung cancer and examine trends and disparities over time in death rates for all cancer sites combined, lung cancer, and all cancer sites excluding lung by sex, race, ethnicity, and rural-urban status. This study contributes new information on deaths from lung cancer relative to deaths from other cancers. Methods: We used 1999-2020 data from the National Vital Statistics System, which captures information on all US deaths. We examined age-adjusted lung cancer death rates in 2020 per 100,000 persons by cancer type, sex, race, ethnicity, and rural- urban status. We calculated the proportion of the difference in 2020 death rates due to lung cancer. We calculated average annual percent change (AAPC) in age-adjusted cancer death rates between 1999-2020 by cancer type, sex, and rural-urban status using Joinpoint regression. Results: In 2020, lung cancer accounted for 23% of all cancer deaths. The age-adjusted death rate for lung cancer was higher for males (38.05) compared to females (26.93). For females, lung cancer death rates by race and ethnicity were highest among White, non-Hispanic females (30.34), and for males, among Black, non-Hispanic males (45.57). Lung cancer death rates were higher in rural vs. urban settings for females (33.55 vs. 25.74) and males (49.04 vs. 35.89). In 2020, 46% and 49% of the rural-urban difference in death rates for all cancers combined among females and males, respectively, was due to lung cancer. During 1999-2020, there were significant declines in death rates for all cancer sites combined, all cancer sites excluding lung, and lung cancer. Larger declines in cancer deaths, including lung cancer, were observed in urban (AAPC range: -1.4 to -3.5) vs. rural (AAPC range: -0.7 to -2.6) settings, leading to increased disparities over time. Conclusion: In 2020, lung cancer death rates were highest among males and in rural settings. Disparities in cancer deaths by rural-urban status have widened over time; half of the difference in disparities for 2020 was due to lung cancer. Partnering with rural communities to identify and address opportunities to improve lung cancer prevention, screening, and treatment may reduce inequities in cancer mortality.
Keywords: lung cancer, mortality, disparities