Abstract Rationale Lung cancer remains the leading cause of cancer-related mortality in the United States. Chronic occupational and environmental lung diseases such as asbestosis, other pneumoconiosis, and hypersensitivity pneumonitis can cause progressive fibrosis and inflammation, potentially increasing the risk and severity of lung cancer. Over the past two decades, evolving workplace safety standards, reduced smoking rates, and improved diagnostic approaches may have influenced the mortality patterns of lung cancer associated with these conditions. Tracking the epidemiological trends and geographical variations in lung cancer mortality associated with occupational and environmental lung diseases over time is essential. Methods We analyzed national mortality data from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database between 1999 and 2020. Lung cancer (ICD-10: C34)-related deaths associated with occupational and environmental lung diseases (ICD-10: J60-J70) in adults aged ≥25 years were examined using the year 2000 U.S. standard population for age standardization. Mortality rates were expressed as age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to assess trends and calculate the annual percentage change (APC), stratified by year, sex, census region, type of facility, and state. Results Between 1999 and 2020, a total of 27572 lung cancer deaths were associated with occupational and environmental lung diseases. The overall AAMR declined from 0.7 in 1999 to 0.5 in 2011 (APC -3.39; 95% CI, -4.61 to -2.15), remained stable for a period, then showed minor fluctuations, returning to 0.5 in 2020 (APC 1.59; 95% CI, -0.65 to 3.90). Males exhibited higher mortality rates than females throughout the study period (0.9 vs. 0.3). Regional variations in AAMR were also significant, with the highest rate in the Midwest and South (0.6 each). In terms of the location of death, 64.70 % died in a hospital. Geographically, AAMRs ranged from 1.3 in West Virginia to 0.2 in New Mexico. Conclusion From 1999 to 2020, lung cancer mortality associated with occupational and environmental lung diseases showed an overall downward trend across the United States. This decline likely reflects improvements in occupational safety standards, reduced exposure to asbestos and silica, heightened awareness of workplace hazards, and a decrease in smoking prevalence among industrial workers. Nonetheless, persistent sex and regional disparities highlight ongoing vulnerabilities. Continued occupational health surveillance, targeted risk reduction, and region-specific prevention strategies remain essential to further mitigate lung cancer burden in populations with prior environmental or occupational exposures. This abstract is funded by: None
Ashraf et al. (Fri,) studied this question.
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