Lung cancer-related stroke mortality in US adults aged ≥45 years declined from 1999 to 2015 but increased significantly from 2015 to 2023 (APC 2.98, P<0.05).
Observational (n=95,328)
Yes
Despite long-term declines, lung cancer-related stroke mortality in the US has risen since 2015, disproportionately affecting older adults, males, and non-Hispanic Blacks.
Effect estimate: AAPC -0.93
p-value: p=<0.05
e20774 Background: Lung cancer is the leading cause of cancer mortality in the U.S., while stroke ranks fourth overall. Shared risk factors, including tobacco use and cancer-associated hypercoagulability, link these conditions. This study evaluates long-term mortality trends and disparities among U.S. adults aged ≥45 years. Methods: We analyzed U.S. mortality data using CDC WONDER (1999-2023) for lung cancer (ICD-10: C34) and stroke (ICD-10: I60–I69) deaths. Age-adjusted mortality rates (AAMRs, per 100,000 population) were calculated using the 2000 U.S. standard population and stratified by age, sex, race/ethnicity, U.S. census region, states, urbanization, and place of death. Joinpoint regression identified trend inflection points, quantified using annual percent change (APC) and average annual percent change (AAPC). Statistical significance was defined as P < .05. Results: From 1999–2023, 95,328 stroke- and lung cancer–related deaths occurred among ≥45 adults, rising 29% despite an overall decline in AAMR (AAPC -0.93). AAMR first declined from 1999–2015 but increased from 2015–2023 across most subgroups. During 2015–2023, males had higher AAMRs (3.20-3.67), but females had a greater rise (APC 3.13). By race/ethnicity, non-Hispanic Blacks had a notable rise (3.36-4.42), and adults aged ≥65 years had the largest increase (5.86-7.10). AAMRs rose more in metropolitan areas (2.58-2.82) than non-metropolitan areas (APC 1.83), with regionally the greatest increase in the Midwest (2.82-3.54) and the smallest in the West (2.41-2.69). Most deaths occurred in inpatient medical facilities (n = 37,792). From 1999–2020, Alaska had the highest AAMR (4.76) and Utah the lowest (1.19); from 2021–2023, Mississippi was highest (5.75) and Utah remained lowest (1.35). Conclusions: Despite long-term declines, lung cancer-related stroke mortality has risen since 2015, disproportionately affecting older adults, males, non-Hispanic Blacks, and residents of the Midwest, Mississippi, and Alaska. This reversal underscores the need for targeted interventions and may reflect increased stroke risk in longer-surviving lung cancer patients, persistent healthcare disparities, and COVID-19-related care disruptions. Annual percent change of for stroke- and lung cancer- related age-adjusted mortality rates among middle aged and older us adults from 1999-2023; stratified by sex, race/ethnicity, age, urbanization and census regions. Variable APC -1999-2015 APC -2015-2023 Overall -2.83* 2.98* Male -3.71* 2.46* Female -1.90* 3.13* NH Black or African American -3.04* a 4.05* b NH White -2.54* 3.02* ≥65 -3.01* 2.85* Metropolitan areas -2.90* c 2.16* d Midwest -2.53* a 3.75* b West -3.37* e 1.62* f Abbreviations: AAMR, age adjusted mortality rate; APC, annual percent change; NH, Non-Hispanic; *Denotes p < 0.05. a: 1999-2016; b: 2016-2023; c : 1999-2015; d: 2015-2020 e: 1999-2014 f - 2014-2023.
Assad et al. (Thu,) conducted a observational in Lung cancer and stroke mortality (n=95,328). Lung cancer-related stroke mortality in US adults aged ≥45 years declined from 1999 to 2015 but increased significantly from 2015 to 2023 (APC 2.98, P<0.05).