Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015

Background: Although lung cancer incidence and mortality have been declining since the 1990s, the extent to which such progress has been made is unequal across population segments. Updated epidemiologic data on trends and patterns of disparities are lacking.Methods: Data on lung cancer cases and dea...

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Main Authors: Yu Jie Zhong, Yi Feng Wen, Hai Ming Wong, Guosheng Yin, Ruitao Lin, Shuan Ying Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fonc.2019.00404/full
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author Yu Jie Zhong
Yi Feng Wen
Hai Ming Wong
Guosheng Yin
Ruitao Lin
Shuan Ying Yang
author_facet Yu Jie Zhong
Yi Feng Wen
Hai Ming Wong
Guosheng Yin
Ruitao Lin
Shuan Ying Yang
author_sort Yu Jie Zhong
collection DOAJ
description Background: Although lung cancer incidence and mortality have been declining since the 1990s, the extent to which such progress has been made is unequal across population segments. Updated epidemiologic data on trends and patterns of disparities are lacking.Methods: Data on lung cancer cases and deaths during 1974 to 2015 were extracted from the Surveillance, Epidemiology, and End Results program. Age-standardized lung cancer incidence and mortality and their annual percent changes were calculated by histologic types, demographic variables, and tumor characteristics.Results: Lung cancer incidence decreased since 1990 (1990 to 2007: annual percent change, −0.9 [95% CI, −1.0%, −0.8%]; 2007 to 2015: −2.6 [−2.9%, −2.2%]). Among adults aged between 20 and 39 years, a higher incidence was observed among females during 1995 to 2011, after which a faster decline in female lung cancer incidence (males: −2.5% [−2.8%, −2.2%]; females: −3.1% [−4.7%, −1.5%]) resulted in a lower incidence among females. The white population had a higher incidence than the Black population for small cell carcinoma since 1987. Black females were the only group whose adenocarcinoma incidence plateaued since 2012 (−5.0% [−13.0%, 3.7%]). A higher incidence for squamous cell carcinoma was observed among Black males and females than among white males and females during 1974 to 2015. After circa 2005, octogenarians and older patients constituted the group with the highest lung cancer incidence. Incidence for localized and AJCC/TNM stage I lung cancer among octogenarians and older patients plateaued since 2009, while mortality continued to rise (localized: 1.4% [0.6%, 2.1%]; stage I: 6.7% [4.5%, 9.0%]).Conclusions: Lung cancer disparities prevail across population segments. Our findings inform effective approaches to eliminate lung cancer disparities by targeting at-risk populations.
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spelling doaj.art-9f99209c5a134237ba901aff43eda6382022-12-22T00:49:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-05-01910.3389/fonc.2019.00404457865Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015Yu Jie Zhong0Yi Feng Wen1Hai Ming Wong2Guosheng Yin3Ruitao Lin4Shuan Ying Yang5Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, ChinaKey Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, ChinaPublic Health and Healthy Ageing Research Group, The University of Hong Kong, Hong Kong, Hong KongDepartment of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, Hong KongDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, ChinaBackground: Although lung cancer incidence and mortality have been declining since the 1990s, the extent to which such progress has been made is unequal across population segments. Updated epidemiologic data on trends and patterns of disparities are lacking.Methods: Data on lung cancer cases and deaths during 1974 to 2015 were extracted from the Surveillance, Epidemiology, and End Results program. Age-standardized lung cancer incidence and mortality and their annual percent changes were calculated by histologic types, demographic variables, and tumor characteristics.Results: Lung cancer incidence decreased since 1990 (1990 to 2007: annual percent change, −0.9 [95% CI, −1.0%, −0.8%]; 2007 to 2015: −2.6 [−2.9%, −2.2%]). Among adults aged between 20 and 39 years, a higher incidence was observed among females during 1995 to 2011, after which a faster decline in female lung cancer incidence (males: −2.5% [−2.8%, −2.2%]; females: −3.1% [−4.7%, −1.5%]) resulted in a lower incidence among females. The white population had a higher incidence than the Black population for small cell carcinoma since 1987. Black females were the only group whose adenocarcinoma incidence plateaued since 2012 (−5.0% [−13.0%, 3.7%]). A higher incidence for squamous cell carcinoma was observed among Black males and females than among white males and females during 1974 to 2015. After circa 2005, octogenarians and older patients constituted the group with the highest lung cancer incidence. Incidence for localized and AJCC/TNM stage I lung cancer among octogenarians and older patients plateaued since 2009, while mortality continued to rise (localized: 1.4% [0.6%, 2.1%]; stage I: 6.7% [4.5%, 9.0%]).Conclusions: Lung cancer disparities prevail across population segments. Our findings inform effective approaches to eliminate lung cancer disparities by targeting at-risk populations.https://www.frontiersin.org/article/10.3389/fonc.2019.00404/fulllung cancertrenddisparityincidencemortality
spellingShingle Yu Jie Zhong
Yi Feng Wen
Hai Ming Wong
Guosheng Yin
Ruitao Lin
Shuan Ying Yang
Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
Frontiers in Oncology
lung cancer
trend
disparity
incidence
mortality
title Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
title_full Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
title_fullStr Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
title_full_unstemmed Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
title_short Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015
title_sort trends and patterns of disparities in burden of lung cancer in the united states 1974 2015
topic lung cancer
trend
disparity
incidence
mortality
url https://www.frontiersin.org/article/10.3389/fonc.2019.00404/full
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