C77-15 Pulmonary Embolism as a Cause of Death in Lung Cancer: Insights From Two Decades of U.S. Mortality Data

Abstract Rationale Lung cancer remains the leading cause of cancer-related deaths in the United States (U.S.), accounting for one in five cancer fatalities. Pulmonary embolism (PE) is a life-threatening condition responsible for approximately 100,000 deaths annually. Although both diseases have been well characterized individually, data describing their combined mortality burden are limited. We evaluated national trends in mortality from coexisting lung cancer and PE and identified the demographic groups at highest risk. Methods Mortality data for adults aged ≥25 years were obtained from the CDC WONDER Multiple Cause of Death database for 1999-2023. Deaths listing both lung cancer and PE were identified using ICD-10 codes. Age-adjusted mortality rates (AAMRs) per one million population (95% confidence intervals CIs) were calculated by standardizing crude rates to the 2000 U.S. census population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results Between 1999 and 2023, 59,727 deaths were attributed to concurrent lung cancer and PE. The overall AAMR increased from 8.02 to 12.49 per million (AAPC = +1.87%; 95% CI: 1.62-2.21). Mortality rose sharply from 1999-2005 (APC = +3.88%; 95% CI: 2.38-6.77), stabilized thereafter, and increased again from 2016-2023 (APC = +2.79%; 95% CI: 1.88-5.15). AAMRs increased in both sexes, with a steeper rise among females (AAPC = +2.69%; 95% CI: 2.34-3.27) than males (AAPC = +1.27%; 95% CI: 0.99-1.60). By race, non-Hispanic (NH) Asian/Pacific Islanders experienced the greatest increase (AAPC = +2.54%; 95% CI: 1.40-4.16), while NH Whites showed the smallest (AAPC = +1.94%; 95% CI: 1.68-2.38). Regionally, the Midwest demonstrated the largest increase (AAPC = +2.28%; 95% CI: 1.89-2.83). Nonmetropolitan areas consistently exhibited higher mortality (AAPC = +1.67%; 95% CI: 1.26-2.17). The highest mortality occurred among adults aged ≥65 years. Vermont had the greatest AAMR until 2020 (16.77), followed by Minnesota in 2023 (20.85). Most deaths occurred in medical facilities. Conclusions Rising mortality from coexisting lung cancer and PE has disproportionately affected NH Asian/Pacific Islander females aged ≥65 years living in nonmetropolitan regions of the Midwest. Unequal access to diagnostic facilities, socioeconomic disparities-including insurance and immigration status-and uneven distribution of healthcare resources may partly explain these patterns. These findings highlight the need for targeted public-health policies and equitable resource allocation to reduce disease burden in vulnerable populations. This abstract is funded by: None