Trends in the Overall Incidence and Mortality of Lung Cancer: An Extensive Longitudinal Study Utilizing the CDC...

Lung cancer remains a leading cause of global mortality despite declining rates. Since 2010, FDA-approved immune checkpoint inhibitors (ICIs) have transformed treatment. This study investigates lung cancer incidence and mortality trends, emphasizing temporal associations with ICI integration and smoking patterns.

Data (1999-2020) were extracted from the CDC WONDER database. Trends were analyzed using joinpoint regression to determine the annual percent change (APC).

Lung cancer incidence declined from 1999 to 2020, with the sharpest decrease post-2018 (APC -6.90) compared to 2006-2018 (APC -1.78). Males saw steeper declines than females; however, American Indians/Alaska Natives showed an increasing trend (APC 3.96). Smoking prevalence decreased overall (1965-2018), though youth smoking rose between 1992 and 2004. By 2018, smoking was highest among American Indians/Alaska Natives (25.9%). Lung cancer mortality declined steadily since 1999, accelerating after 2014 (APC -4.10). Conversely, cardiovascular (CVS) mortality decline decelerated after 2015, stabilizing between 2018 and 2020 (APC 0.82; 95% CI -0.53 to 1.81).

Lung cancer incidence and mortality declined significantly over two decades. The accelerated mortality declines post-2014 coincide with the clinical integration of ICIs. The stabilization of CVS mortality after 2015 reflects a shift in the clinical profile, potentially related to competing risks and ICI-related trends, warranting further investigation into whether population-level CVS mortality is influenced by immunotherapy.