Trends in COPD and Lung Cancer Associated Mortality in the U.S (1999-2020):A Population-Based Study Using CDC WONDER

Background: COPD and lung cancer are major global respiratory diseases, with COPD causing irreversible airflow limitation and lung cancer remaining a leading cause of cancer-related deaths.Analyzing mortality trends and health disparities is crucial for shaping effective public health policies and refining prevention strategies for diseases like COPD and lung cancer. Methods: Data was extracted from the CDC WONDER database, the ICD-10 codes used were C34.0-C34.3, C34.8, C34.9 and J41-J44. Age groups were categorized from 25 to 85 and above. We applied Joinpoint regression to calculate both annual and average annual percent change (AAPC) in mortality trends. Data were analyzed based on demographics, census regions, and levels of urbanization. Results: From 1999 to 2020 the total deaths recorded in U.S. were 484941. There was a significant decrease in the AAMR from 1999-2020 (AAPC: -1.40; 95% CI -1.79 to –1.00). COPD and lung cancer-related AAMRs were consistently higher in males than females, with NH White individuals having the highest rates and NH Asian or Pacific Islanders the lowest. Most racial groups saw declining mortality trends from 1999 to 2020, with notable reductions among Hispanics and NH Asian or Pacific Islanders, while NH White individuals initially experienced a slight increase before a steady decline. Nonmetropolitan areas consistently exhibited higher mortality rates than metropolitan areas, initially rising before trending downward, while metropolitan regions saw a continuous decline. Mortality patterns varied by location, with most deaths occurring at home or in medical facilities. Regionally, the Midwest reported the highest AAMR, while West Virginia had the highest state-level mortality rate and Utah the lowest. Conclusion Although COPD and lung cancer mortality have declined overall, persistent disparities across gender, race, and geographic regions underscore inequities in healthcare access. Targeted interventions are essential to bridge these gaps and improve COPD and lung cancer care nationwide.