Abstract TP186: Comorbid Lung Cancer and Cerebrovascular Disease-Associated Mortality Trends and Disparities in the United States From 1999 to 2019 – A CDC WONDER Database Analysis

Introduction: Cancer and cerebrovascular disease (CeVD) are leading causes of death in developed countries, and lung cancer, the most commonly diagnosed cancer worldwide, is strongly associated with an increased risk of CeVD. The contemporary mortality trends related to these two conditions have not been thoroughly studied. This study explores the national mortality trends with concomitant lung cancer and CeVD from 1999 to 2019. This might help identify healthcare inequities and address them to control the disease burden. Methods: The mortality data was retrieved from the Centers for Disease Control and Prevention’s database, CDC WONDER, to extract age-adjusted mortality rates (AAMR) per 100,000 population from 1999 to 2019 among individuals aged > 25 years. Lung cancer was identified using ICD-10 code C34, and CeVD was identified using ICD-10 codes I60-I69. Those mortalities were included in the analysis where they were either the underlying or contributing cause of death. Trends were analyzed by year, sex, race/ethnicity, census region, and metropolitan status. Joinpoint regression was used to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Results: From 1999 to 2019, a total of 76,797 deaths occurred in patients with coexisting CeVD and lung cancer, with an overall AAMR of 1.69/100,000. The AAMR decreased from 2.19 in 1999 to 1.53 in 2019, showing a significantly decreasing trend from 1999 to 2014 (APC: -2.93, p < 0.001), followed by a stable trend from 2014 to 2019 (APC: 1.06, p = 0.06). Men had a higher AAMR (2.14) than women (1.36). The Black or African American population had the highest AAMR (2.25), followed by White (1.77), American Indian or Alaska Native (1.31), Asian or Pacific Islander (1.02), and Hispanic or Latino (0.70). Significant geographical variations were also observed, with the Midwest region (1.89) and the state of Alaska (2.59) having the highest AAMR. AAMR in nonmetropolitan areas (2.06) was higher compared to that in metropolitan (1.61) areas. Conclusion: The mortality trend related to coexisting lung cancer and CeVD decreased for most of the study period, but plateaued in the later years. The decline in mortality has leveled off since 2015, perhaps due to limited advances in prevention and continued sociodemographic health disparities highlighted by the study. This underscores the need for further research and targeted interventions.