e23372 Background: Lung cancer is the leading cause of oncological mortality in the U.S, a burden frequently increased by co-occurring renal failure, which impairs systemic drug metabolism and significantly elevates the risk of treatment-related complications. This study aims to analyze and interpret annual mortality trends and disparities among adults in the United States from 1999 to 2023, for various demographic and geographic factors. Methods: The mortality data from the CDC WONDER multiple cause of death files for adults aged ≥25 years were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 1,000,000 through ICD 10 code: C34 (lung cancer) and ICD 10 code: N17-N19 (renal failure), stratified by year, gender, race/ethnicity, place of death and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: From 1999 to 2023, a total of 93,566 deaths were reported where lung cancer and renal failure co-occurred, most occurring among medical facility inpatient settings. The overall AAMR increased from 14.21 in 1999 to 18.67 in 2023 (AAPC: 0.93; 95% CI: -0.44 to 2.33; p = 0.18). An initial decline in AAMR was observed between 2011 and 2017 (APC: -6.61; p = 0.004), followed by a notable increase through 2023 (APC: 6.71; p < 0.001). The overall annual rise in mortality was significant among women (AAPC: 2.43; p < 0.001), although AAMR was higher in men than women (24.74 vs 11.07). Adults aged 65 and above experienced the highest CMR (69.52). By race, non-Hispanic (NH) Blacks had the highest AAMR (28.28), while NH Asians had the lowest (11.41). Geographic disparities were evident, with the Midwest having the greatest AAMR (18.38) and the West having the least (14.97). Non-metropolitan areas had a higher AAMR than metropolitan areas (18.63 vs 15.91), along with a steeper rise in mortality (AAPC: 0.52 vs -0.49). At the state level, Kentucky and Indiana ranked highest, both falling within the top 90th percentile during 1999–2020 and 2021–2023, respectively. Conclusions: Mortality related to lung cancer and co-occurring renal failure has increased over the past two decades, with disproportionate burden among older adults, men, NH Black individuals, those residing in non-metropolitan areas, and the Midwest region. This underscores the need for targeted prevention, early detection, and provision of equitable healthcare. Average annual percent change (AAPC) of Lung Cancer and Renal Failure related age-adjusted mortality rates in the United States, 1999 to 2023. Variable Deaths AAPC (95%CI) Overall 93,566 0.93 (-0.44 to 2.33) Male 58,332 -0.34 (-2.73 to 2.11) Female 35,234 2.43 (0.95 to 3.93) Non-metropolitan areas 15,768 0.52 (-2.05 to 3.16) Metropolitan areas 62,525 -0.49 (-2.70 to 1.76)
Kumari et al. (Thu,) studied this question.