Temporal trends and forecasted mortality involving lung cancer with co-listed hypertension in U.S. adults, 2000-2035

Lung Cancer (LC) and Hypertension (HTN) frequently co-exist as a significant comorbidity with shared risk factors and pathophysiological mechanisms. We examined national trends and forecast future mortality involving LC co-listed with HTN among US adults from 2000 to 2025, with projections to 2035.

Using CDC WONDER MULTIPLE Cause-of-Death, we conducted a retrospective analysis of LC and co-listed HTN mortality from 2000 to 2025 among adults aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) were calculated, and joinpoint regression was utilized to estimate annual average percentage changes (AAPCs) with 95% confidence intervals (CIs). Auto-ARIMA and Prophet time-series models in R (v4.5.0) projected AAMRs through 2035, evaluated by root mean squared error (RMSE).

There were 305,878 reported deaths due to LC and co-listed HTN. The AAMR rose from 3.55 to 6.00 (AAPC 2.038; p < 0.0001). Men had higher mean AAMRs than women (mean AAMR: men 6.16; women 4.07). Among races, Non-Hispanic (NH) Black adults had the greatest mortality (mean AAMR: 7.38). Geographically, the South had the greatest burden (mean AAMR: 5.67) and non-metropolitan regions had higher mean AAMR than metropolitan regions (5.73 vs. 4.5). Most deaths (42.16%) occurred in decedents' homes. The overall AAMR was projected to remain persistently elevated through 2035, particularly among men, NH White individuals, and in the Southern region with substantial uncertainty.

Mortality associated with LC and co-listed HTN is an increasing healthcare burden in the US with marked demographic and regional disparities. Future projections indicate a persistent mortality burden, underscoring the need for targeted prevention strategies.