Grobman Benjamin, Mansur Arian, Lu Christine Y
Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA.
Lung. 2024 Dec 6;203(1):13. doi: 10.1007/s00408-024-00756-5.
Patients with chronic lower respiratory diseases (CLRD) are at a higher risk of lung cancer. Less is known regarding how the risk of CLRD-associated lung cancer death might have changed on a national scale over the past 20 years across demographic and regional groups.
We calculated age-adjusted mortality rates (AAMR) for lung cancer death among people with CLRD using 1999-2020 data from the CDC WONDER multiple cause of death database. Rates were compared between demographic groups and time periods.
Rates of lung cancer death among people with CLRD were highest among White Americans compared to other racial groups. Elevated rates of lung cancer death were seen among men (AAMR = 25.054, 95% CI: 24.960-25.148) and those aged 65 + (AAMR = 44.776, 95% CI: 44.638-44.913) compared to their counterparts. Rates were higher in the Midwest (AAMR ratio = 1.410, 95% CI: 1.401-1.418) and the South (AAMR ratio = 1.290, 95% CI: 1.282-1.298) compared to the Northeast. Rates were elevated in rural areas (AAMR ratio = 1.444, 95% CI: 1.438-1.451). Between 1999 and 2004 and 2016-2020, the AAMR of CLRD-associated lung cancer death decreased from 21.647 (95% CI: 21.528-21.765) to 17.221 (95% CI: 17.123 - 17.318). Rates decreased over time across demographic groups.
CLRD-associated lung cancer deaths significantly decreased in the United States between 1999 and 2020. Despite this progress, White people, men, older adults (65 +), and people in rural areas continue to experience higher CLRD-associated lung cancer mortality rates than their counterparts.
慢性下呼吸道疾病（CLRD）患者患肺癌的风险更高。关于过去20年中，在全国范围内，CLRD相关肺癌死亡风险在不同人口统计学和地区群体中可能发生了怎样的变化，我们所知较少。
我们使用美国疾病控制与预防中心（CDC）的多死因数据库中1999 - 2020年的数据，计算了CLRD患者肺癌死亡的年龄调整死亡率（AAMR）。对不同人口统计学群体和时间段的死亡率进行了比较。
与其他种族群体相比，美国白人中CLRD患者的肺癌死亡率最高。与相应人群相比，男性（AAMR = 25.054，95%置信区间：24.960 - 25.148）和65岁及以上人群（AAMR = 44.776，95%置信区间：44.638 - 44.913）的肺癌死亡率升高。与东北部相比，中西部地区（AAMR比率 = 1.410，95%置信区间：1.401 - 1.418）和南部地区（AAMR比率 = 1.290，95%置信区间：1.282 - 1.298）的死亡率更高。农村地区的死亡率也有所升高（AAMR比率 = 1.444，95%置信区间：1.438 - 1.451）。在1999年至2004年以及2016年至2020年期间，CLRD相关肺癌死亡的AAMR从21.647（95%置信区间：21.528 - 21.765）降至17.221（95%置信区间：17.123 - 17.318）。随着时间推移，各人口统计学群体的死亡率均有所下降。
1999年至2020年期间，美国CLRD相关肺癌死亡人数显著下降。尽管取得了这一进展，但白人、男性、老年人（65岁及以上）以及农村地区居民的CLRD相关肺癌死亡率仍高于相应人群。
