A 25 year nationwide analysis of mortality trends from cerebrovascular diseases in patients with lung cancer (1999–2023)

Abstract

Introduction: The two leading causes of death worldwide are lung cancer and cerebrovascular disease (CVD). Due to complications related to the disease and therapy, patients with lung cancer are much more likely to have a stroke, particularly within 2 years after diagnosis. Results are still poor despite medical advancements, underscoring the necessity of comprehensive prevention and care. Methods: ICD-10 codes for lung cancer (C34) and cerebrovascular illness (I60–I69) were used to evaluate mortality data from CDC WONDER (1999–2023). When both illnesses were listed on death certificates, deaths were counted. Sex, race/ethnicity, area, and urban/rural status were used to compute age adjusted mortality rates (AAMRs). Joinpoint regression was used to evaluate trends, and P < 0.05 was considered significant. Results: Overall AAMR for CVD and lung cancer decreased from 2.19 to 1.44 per 100 000 (APC: −2.9; P < 0.0001) between 1999 and 2015, subsequently increased to 1.71 in 2023 (APC: +2.8; P < 0.0001). From 3.08 in 1999 to 1.98 in 2023, men’s rates were continuously higher than women’s (1.59 to 1.49). The AAMR was highest among NH Black people (it peaked at 2.32 in 2023), followed by NH Whites (1.68) and Hispanics (0.69). Rural areas had higher AAMR than Urban areas. Alaska (2.57), Vermont (2.46), and Mississippi (2.46) had the highest state level burdens, while Utah (0.64) and New Mexico (0.86) had the lowest, while the South and Midwest region saw the sharpest recent rises. Conclusion: Lung cancer mortality from CVD increased until 2023 after decreasing until 2015. The U.S. South, rural areas, Black adults, and men had the biggest burden. To lower stroke mortality in patients with lung cancer, targeted interventions are required, with a focus on addressing racial and rural disparities in care, prevention, and access.