Temporal trends and forecasted mortality involving lung cancer with co-listed hypertension in U.S. adults, 2000-2035.

Abstract

Background: Lung Cancer (LC) and Hypertension (HTN) frequently co-exist as a significant comorbidity with shared risk factors and pathophysiological mechanisms. We examined national trends and forecast future mortality involving LC co-listed with HTN among US adults from 2000 to 2025, with projections to 2035.

Methods: Using CDC WONDER MULTIPLE Cause-of-Death, we conducted a retrospective analysis of LC and co-listed HTN mortality from 2000 to 2025 among adults aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) were calculated, and joinpoint regression was utilized to estimate annual average percentage changes (AAPCs) with 95% confidence intervals (CIs). Auto-ARIMA and Prophet time-series models in R (v4.5.0) projected AAMRs through 2035, evaluated by root mean squared error (RMSE).

Results: There were 305,878 reported deaths due to LC and co-listed HTN. The AAMR rose from 3.55 to 6.00 (AAPC 2.038; p < 0.0001). Men had higher mean AAMRs than women (mean AAMR: men 6.16; women 4.07). Among races, Non-Hispanic (NH) Black adults had the greatest mortality (mean AAMR: 7.38). Geographically, the South had the greatest burden (mean AAMR: 5.67) and non-metropolitan regions had higher mean AAMR than metropolitan regions (5.73 vs. 4.5). Most deaths (42.16%) occurred in decedents' homes. The overall AAMR was projected to remain persistently elevated through 2035, particularly among men, NH White individuals, and in the Southern region with substantial uncertainty.

Conclusion: Mortality associated with LC and co-listed HTN is an increasing healthcare burden in the US with marked demographic and regional disparities. Future projections indicate a persistent mortality burden, underscoring the need for targeted prevention strategies.