Abstract Rationale Lung cancer remains the leading cause of cancer-related deaths, accounting for one in five fatalities in the United States (U.S.). Interstitial lung disease (ILD) is an important risk factor that increases the morbidity and mortality of lung cancer. The coexistence of these conditions leads to disproportionately poorer outcomes despite advances in antifibrotic and oncologic therapies. There is a growing need to identify high-risk communities, highlight disparities, and assess temporal mortality trends related to lung cancer and ILD to help mitigate this burden. Methods We extracted de-identified data from the CDC WONDER database using ICD-10 codes C34 (lung cancer) and J84 (interstitial lung disease). Crude mortality rates (CRs) and age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 population. Annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs) were estimated using Joinpoint regression software. Results From 1999 to 2023, 22,376 deaths were recorded due to lung cancer among adults with ILD. The AAMR increased from 6.90 in 1999 to 9.13 in 2023 (AAPC: +1.08; 95% CI: 0.83-1.37). Although males had higher AAMRs than females, the increase was greater in females (AAPC: +1.61; 95% CI: 1.21-2.04) than in males (AAPC: +0.66; 95% CI: 0.37-0.96). By race, AAMRs were higher in the non-Hispanic (NH) White population than in NH Black individuals, with a steeper rise among NH White individuals (AAPC: +1.31; 95% CI: 1.07-1.59 vs. +0.95; 95% CI: -0.44 to 2.25). Regionally, the Midwest had the highest AAMRs, while the Northeast showed the greatest increase (AAPC: +1.59; 95% CI: 1.10-2.18). Rural areas had persistently higher AAMRs, yet urban regions demonstrated a steeper rise (Urban AAPC: +0.65; 95% CI: 0.29-1.02 vs. Rural AAPC: +0.24; 95% CI: -0.66 to 1.23). States with the highest AAMRs included Montana, Oregon, Washington, South Dakota, and Kentucky. Age-stratified analysis revealed the highest mortality burden among individuals aged ≥65 years (AAPC: +1.36; 95% CI: 1.06-1.70), followed by those aged 45-64 years (AAPC: -0.55; 95% CI: -1.13 to 0.03). Conclusions Between 1999 and 2023, lung cancer-related mortality among patients with ILD in the U.S. increased steadily, particularly among older non-Hispanic White females in Northeastern urban regions. This trend likely reflects greater diagnostic awareness and wider adoption of CT imaging. Recognizing these high-risk populations is crucial for guiding targeted interventions and public health strategies to reduce mortality and improve outcomes.. This abstract is funded by: None
Ali et al. (Fri,) studied this question.