Racial disparities in lung cancer incidence and mortality over the last two decades; a Population-Based Study

Abstract

Abstract Background Racial disparities in the incidence and survival of lung cancer patients have been thoroughly studied. However, large epidemiologic studies evaluating temporal trends based on race are not prevalent. In this study, we aim to evaluate trends of incidence and mortality of lung cancer patients with a focus on patients of Asian origins. Methods We used SEER 18 database to study lung cancer cases in the US during 2000-2015. Incidence and mortality rates of lung cancer were calculated by race and were expressed by 100,000 person-years. Annual percent change (APC) was calculated using joinpoint regression software. All statistical tests were two-sided. Results 794,319 patients with lung cancer were identified. Most patients were whites (83.32%), followed by blacks (10.85%), Asians (5.37%), and American Indians (4.68%), with incidence rates of 60.86, 67.538, 37.325, and 32.195 per 100,000 person-years, respectively. Incidence rates of lung cancer decreased significantly among Asians during the study period, with this decrease being more prominent since 2012 (APC=-3.148%, p-value= 0.018). Similar trends were observed in other races. Mortality due to lung cancer was 49.001, 56.245, 28.916, and 27.980 per 100,000 person-years in whites, blacks, Asians, and American Indians, respectively. Mortality rates of both Asians increased significantly from 2000-2009 (APC=2.429%, P Conclusion Patients of Asian origins have shown lower incidence and mortality rates of lung cancer when compared to whites or blacks. Despite the declining incidence of lung cancer in Asians, mortality was inclining early 2000s yet started to decline since 2013. Understanding the root causes of the earlier incline and later decline can help improve survival in Asian lung cancer patients and lead to a further decline in mortality rates in the near future.