A105-23 Lung Cancer: Outcomes in Rural Populations

Abstract Introduction Lung cancer remains a significant contributor to morbidity and mortality in the United States. Genetic predisposition to lung cancer is known, while exposures including smoking, poor diet, and occupational hazards also increase one’s risk of developing malignancy. Although advancements have been made in early diagnosis and treatment, disparities persist in rural populations. We aim to explore differences in outcomes in those diagnosed with lung cancer in a rural population compared to the greater United States. Methods We utilized TriNetX, a global de-identified research network, to perform a retrospective cohort study. Inclusion criteria required an ICD-10 code diagnosis of malignant neoplasm of the bronchus and lung from October 2020 to October 2025. Patients diagnosed with diabetes mellitus, atherosclerotic heart disease, chronic kidney disease, essential hypertension, and obesity were excluded due to differences in prevalence of comorbidities, increasing risk for morbidity and mortality. 24,170 patients from the West Virginia University patient cohort and 644,860 patients from the United States cohort met the inclusion criteria. Primary outcomes were risk of hospitalization and mortality. Secondary outcomes included analysis of patient demographics and common comorbidities. A chi-squared contingency test (p-value 0.05) was used to determine statistical significance. Results The West Virginia cohort was younger (73.8 years) than the US cohort (74.8 years), while the US cohort had a higher percentage of females (49.9%) and a lower rate of males (50.5%) than the West Virginia cohort. Among the three most common comorbidities of patients diagnosed with a malignant neoplasm of the bronchus and lung, those in the US cohort had a higher percentage of osteoarthritis (10.9%), cerebrovascular disease (6.8%), and emphysema (7.0%). A statistically significantly greater risk of death (58.2% vs. 38.2%) and hospitalization (64.8% vs. 38.9%) was noted for those localized to West Virginia compared to the greater United States (p 0.05). Conclusion Differences in morbidity and mortality exist between rural populations and the general United States population. Although advancements have been made in the early diagnosis and screening for lung cancer, a greater focus is needed for patients localized to predominantly rural populations. This abstract is funded by: None