Trends in lung cancer mortality in the United States from 1969 to 2020: A SEER-based population study.

238 Background: Lung and bronchial cancers remain among the deadliest malignancies worldwide, accounting for the highest cancer-related mortality in both men and women. Although multiple preventive strategies have been identified and treatment strategies have advanced considerably over the past decades, the benefits of these improvements may not be equitably distributed across all population groups. This study examines long-term trends in lung cancer mortality from 1969 to 2020 with the specific aims of highlighting disparities across demographic groups using data from the SEER program and U.S. mortality records. Methods: This population-based study utilized data from the Surveillance, Epidemiology, and End Results (SEER) program, which captures nearly half of the U.S. population. We analyzed newly diagnosed lung and bronchial cancer cases from 1969 to 2020. Age-standardized mortality rates per 100,000 individuals were calculated and adjusted to the 2000 U.S. standard population. Trends in overall, sex-specific, race-specific, and state-specific mortality were evaluated using the Joinpoint Regression Program to estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Results: Lung cancer mortality declined slightly from 35.5 (95% CI: 35.3–35.8) to 31.8 per 100,000 from 1969 to 2020 (AAPC: –0.24%, p < 0.01). However, sex-stratified analysis demonstrated that while male mortality decreased significantly from 65.0 (95% CI: 64.4–65.6) to 38.0 (AAPC: –1.04%, p < 0.01), female mortality increased from 12.2 (95% CI: 12.0–12.4) to 26.8 per 100,000 (AAPC: +1.55%, p < 0.01). However, in more recent years (2013–2020 for males and 2014–2020 for females), mortality has declined more steeply, with APCs of –5.03% and –4.28%, respectively ( p < 0.01). Racial analysis showed a greater decline among the Black population, from 39.7 (95% CI: 38.7–40.8) to 32.3 (AAPC: –0.41%, p < 0.01), compared to the White population, which declined from 35.2 (95% CI: 34.9–35.5) to 32.6 (AAPC: –0.18%, p < 0.01). Similar declines were observed across other racial groups. State-level analysis revealed the highest mortality rates in Kentucky, followed by West Virginia and Arkansas. Conclusions: While lung cancer mortality has declined overall in recent decades, gender- and race-based disparities persist. These findings highlight the need for targeted public health interventions, improved screening, and equitable access to prevention and treatment strategies.