Escalating cancer mortality in ILD patients: insights from a US population study

Emerging evidence suggests that Interstitial Lung Diseases (ILD) may be associated with a higher risk of cancer in various organ systems compared to the general population. However, epidemiological data on cancer-related mortality in ILD patients remain largely unexamined. We aimed to provide a comprehensive analysis of cancer-related mortality in decedents with ILD across the United States.

We utilized the multiple cause-of-death database provided by CDC, and we analyzed ILD-cancer related Age-Adjusted Mortality Rates (AAMR) stratified by gender, race, state of death, and cancer categories from 1999 to 2019. Transport injury-related mortality was used as a control group. We also analyzed the annual trends of mortality using Average Annual Percent Change (AAPC).

Between 1999 and 2019, a total of 511,176 ILD patients died, with 50,333 (9.85%) concurrently diagnosed with some form of cancer. During this period, the ILD-cancer related AAMR increased by 8.2%, rising from 11.415 to 12.347 per 1,000,000. Decedents with ILD had 23-fold higher odds of having cancer recorded as a cause of death compared to the control group.

Our results suggest that cancer-related mortality is higher in decedents with ILD compared to the control group, with an upward trend observed over the 21-year study period, contrasting with the declining cancer mortality seen in the United States. These findings underscore the need for future prospective studies to determine whether targeted screening and follow-up interventions may benefit this high-risk group.