Background This study aimed to retrospectively analyze secular trends in respiratory failure-associated mortality (AAMR) and its demographic and geographic variations among US adult cancer patients from 1999 to 2023. Methods This study conducted a comprehensive retrospective analysis of respiratory failure-associated mortality data from 1999 to 2023 among US adult cancer patients and assessed secular trends (AAPC/APC) as well as variations across geographic, urban/rural, and racial/ethnic subgroups. Results During the study period, the overall age-adjusted mortality rate (AAMR) demonstrated a statistically significant long-term decline (AAPC: −0.60, 95% CI: −0.87 to −0.33, P 0.05). However, this trend was punctuated by a synchronized and significant surge in AAMR across all subgroups between 2018 and 2021, with Annual Percentage Changes (APCs) of 5.02 (95% CI: 3.52–6.55) for males and 5.56 (95% CI: 3.29–7.89) for females ( P 0.05). Persistent health inequities were identified: non-Hispanic Black individuals (AAMR: 2023: 34.56, 95% CI: 33.86–35.26) and residents in non-metropolitan areas (AAMR: 2023: 30.52, 95% CI: 29.99–31.05) exhibited markedly higher mortality risks compared to other racial and geographic cohorts ( P 0.05). Conclusion The collective reversal in respiratory failure-associated mortality after 2018, likely driven by cumulative treatment toxicities and pandemic-related disruptions, highlights a critical shift in cancer survivorship risks. Persistent racial and urban-rural inequities underscore systemic barriers to specialized care. To mitigate this rising burden, it is essential to institutionalize interdisciplinary oncology-pulmonary collaboration and implement targeted screening for high-risk populations.
Xia et al. (Tue,) studied this question.