Jonathan Bryant-Genevier, PhD1; Christine M. Kava, PhD, MA1,2; Stephanie C. Melkonian, PhD1; David A. Siegel, MD, MPH1 (View creator affiliations)
Urged quotation for this text: Bryant-Genevier J, Kava CM, Melkonian SC, Siegel DA. State and Regional Traits in Incidence and Early Detection of Lung Most cancers Amongst US Adults, 2010–2020. Prev Continual Dis 2024;21:240016. DOI: http://dx.doi.org/10.5888/pcd21.240016.
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2010–2019 US age-adjusted state-level lung most cancers incidence charges per 100,000 customary inhabitants with common annual % change (AAPC) for feminine adults (Map A) and male adults (Map B). Incidence and AAPC vary from lowest, A1, to highest, C3. Supply: US Most cancers Statistics, Facilities for Illness Management and Prevention (10). [A text description of this figure is available.]
Background
Lung most cancers is the main reason for most cancers demise in each female and male adults within the US (1,2). General incidence charges of lung most cancers proceed to say no following historic declines in cigarette smoking, estimated to account for roughly 90% of lung most cancers instances (3,4). Nevertheless, disparities in incidence persist amongst sure racial and ethnic teams and between sexes. For instance, current studies have proven charges remaining secure amongst feminine non-Hispanic Asian and Pacific Islander (NH-API) individuals and feminine non-Hispanic American Indian or Alaska Native (NH-AIAN) individuals (1).
Though current advances in remedy, together with focused therapies, have improved mortality charges (5), early detection stays important; survival is considerably increased amongst sufferers presenting with localized illness (4). Latest research have proven that lung most cancers screening, first beneficial by the US Preventive Companies Process Power (USPSTF) in 2013 for individuals at excessive danger for creating lung most cancers, stays low (6) and counsel that geographic disparities exist in entry to high-quality lung most cancers screening services (7).
State and regional developments in lung most cancers incidence and the proportion of instances recognized at localized-only stage haven’t been lately described (8,9). We measured geographic developments in incidence and the proportion of latest instances recognized at localized-only stage, amongst female and male adults and by race and ethnicity, from 2010 via 2019.
Information and Strategies
We used knowledge from the US Most cancers Statistics (USCS) Incidence Analytic Database, that are from population-based registries that take part within the Facilities for Illness Management and Prevention’s (CDC’s) Nationwide Program of Most cancers Registries or the Nationwide Most cancers Institute’s Surveillance, Epidemiology, and Outcomes (SEER) Program and meet high-quality knowledge standards (10). Included registries lined roughly 100% of the US inhabitants from 2010 via 2019; knowledge from 50 states and the District of Columbia have been included (10). Annual incidence charges have been calculated per 100,000 individuals and age-adjusted to the 2000 US customary inhabitants (19 age teams, Census P25–1130). Single yr knowledge from 2020 have been analyzed individually, because the COVID-19 pandemic disrupted well being providers and should have contributed to declines in incidence; Indiana and Nevada have been excluded from the 2020 evaluation as a result of the info for that yr didn’t meet USCS requirements of information high quality. Most cancers instances have been staged utilizing Merged Abstract Stage classes; incidence charges and proportions of instances recognized at localized-only stage (ie, illness restricted to the organ of origin) have been calculated (10,11). Traits in charges and proportions from 2010 via 2019 have been estimated by common annual % change (AAPC) and 2-sided assessments to find out if AAPCs had important variations from zero; charges have been described as rising (AAPC > 0; P < .05), reducing (AAPC < 0; P < .05), or secure (P > .05). Analyses have been carried out utilizing SEER*Stat software program (model 8.4.1, Nationwide Most cancers Institute) and Joinpoint Regression Program (model 4.9.1.0, Nationwide Most cancers Institute). To attenuate racial misclassification of NH AI/AN populations, analyses amongst these populations used the USCS AI/AN Incidence Analytic Database and have been restricted to bought or referred care supply space counties inside or adjoining to federally acknowledged tribal lands (12,13).
Highlights
Incidence charges declined 1.8% per yr on common from 2010 via 2019, reducing extra quickly amongst male adults (AAPC, −2.6%) than amongst feminine adults (AAPC, −1.0%). From 2010 via 2019, lung most cancers incidence declined in 49 jurisdictions and remained secure in 2 jurisdictions amongst male adults and declined in 26 jurisdictions, remained secure in 23 jurisdictions, and elevated in 2 jurisdictions amongst feminine adults. The bottom incidence and quickest declines in incidence have been noticed within the West (Desk). From 2010 via 2019, charges amongst NH-API adults declined lower than these amongst NH White, NH Black, and Hispanic adults throughout all geographic areas; within the Northeast, charges amongst NH API adults have been secure from 2010 via 2019 (Desk). The best declines in incidence have been noticed amongst NH Black adults, though 10-year charges have been increased than NH White adults within the Midwest and West.
In 2020, 25.5% of lung most cancers instances amongst male adults and 30.6% amongst feminine adults, nationally, have been recognized at localized-only stage. From 2010 via 2019, the proportion of instances recognized at localized-only stage rose amongst male (AAPC, 4.9%; 95% CI = 3.5%–6.2%) and feminine (AAPC, 4.5%; 95% CI = 3.3%–5.8%) adults (knowledge not proven). State-level proportions of instances recognized at localized-only stage (Determine) have been comparable between male (vary, 16.6%–24.7%) and feminine (vary, 22.9%–31.0%) adults, with most jurisdictions exhibiting comparable will increase throughout sexes from 2010 via 2019 (AAPC vary: male adults, 2.6%–8.9%; feminine adults, 3.1%–7.6%). General, these knowledge counsel a constant pattern towards earlier stage diagnoses amongst female and male adults; will increase, nonetheless, diversified by state.
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Determine.
2010–2019 US state-level proportion of lung cancers recognized at localized-only stage with AAPC for feminine adults (Map A) and male adults (Map B). Proportions and AAPC vary from lowest, D1, to highest, F3. Supply: US Most cancers Statistics, Facilities for Illness Management and Prevention (10). [A text description of this figure is available.]
Motion
These maps describe current state-specific developments and geographic variation in lung most cancers incidence and early prognosis within the US and current a benchmark for future work to judge implementation of USPSTF 2021 expanded lung most cancers screening suggestions. Alongside contextual proof, reminiscent of state and native tobacco management actions, these knowledge might present perception into future prevention methods, facilitate programmatic improvement, and assist tobacco management and lung most cancers screening efforts (14). Will increase within the proportion of lung most cancers instances recognized at a localized-only stage coincide with the implementation of the 2013 USPSTF lung most cancers screening suggestions and the US Facilities for Medicare and Medicaid Companies guaranteeing personal insurance coverage and Medicare protection in 2015. Geographic variability in lung cancers recognized at localized-only stage could also be attributable partially to variations in availability of screening services (7) or use of screening suggestions, particularly use of low-dose computed tomography, on the state degree (6,15). These patterns differed from lung most cancers incidence developments, which could replicate variations in population-based tobacco-control methods, reminiscent of smoke-free legal guidelines and state tobacco management packages, which have been proven to cut back the prevalence of smoking.
Acknowledgments
The authors thank Jane Henley, MSPH, and Gabriele Richardson, PhD, for his or her help with knowledge interpretation and visualization. The authors acquired no exterior monetary assist for the analysis, authorship, or publication of this text. The authors declare no potential conflicts of curiosity with respect to the analysis, authorship, or publication of this text. No copyrighted materials, surveys, devices, or instruments have been used on this analysis. The findings and conclusions on this manuscript are these of the authors and don’t essentially symbolize the official place of CDC.
Writer Data
Corresponding Writer: Jonathan Bryant-Genevier, PhD, Division of Most cancers Prevention and Management, Nationwide Middle for Continual Illness Prevention and Well being Promotion, Facilities for Illness Management and Prevention, Mailstop S107-4, 4770 Buford Hwy, Atlanta, GA 30341 (phv4@cdc.gov).
Writer Affiliations: 1Division of Most cancers Prevention and Management, Nationwide Middle for Continual Illness Prevention and Well being Promotion, Facilities for Illness Management and Prevention, Atlanta, Georgia. 2Epidemic Intelligence Service, Facilities for Illness Management and Prevention, Atlanta, Georgia.
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Desk
| Variable | US Division of Well being and Human Companies area | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All | Northeast | Midwest | South | West | |||||||||||
| 2020 Feea,b | 10-12 months feec | AAPCd | 2020 Fee | 10-12 months fee | AAPC | 2020 Fee | 10-12 months fee | AAPC | 2020 Fee | 10-12 months fee | AAPC | 2020 Fee | 10-12 months fee | AAPC | |
| General | 57.9 | 72.8 | −1.8 | 60.7 | 76.0 | −1.4 | 67.1 | 80.9 | −1.3 | 61.3 | 77.2 | −1.9 | 41.7 | 54.9 | −2.6 |
| Age, y | |||||||||||||||
| <40 | 1.1 | 1.3 | −1.2 | 1.1 | 1.5 | −0.9e | 1.3 | 1.3 | −2.3e | 1.2 | 1.3 | −0.8e | 0.8 | 1.0 | −0.8e |
| 40−49 | 9.2 | 13.1 | −5.3 | 10.2 | 14.3 | −4.0 | 11.3 | 15.6 | −5.2 | 9.9 | 14.6 | −6.5 | 5.6 | 7.7 | −3.7 |
| 50−59 | 50.3 | 67.3 | −2.1 | 52.4 | 68.7 | −1.9 | 61.9 | 77.8 | −1.2 | 55.7 | 76.8 | −2.5 | 29.1 | 40.3 | −3.6 |
| 60−69 | 154.2 | 181.0 | −1.7 | 159.1 | 186.9 | −1.4 | 181.5 | 202.0 | −0.9 | 168.4 | 198.2 | −1.8 | 100.8 | 127.3 | −2.8 |
| 70−79 | 261.6 | 335.2 | −1.7 | 276.6 | 352.9 | −1.4 | 296.1 | 371.7 | −1.4 | 273.8 | 346.0 | −1.5 | 197.5 | 266.0 | −2.8 |
| ≥80 | 220.7 | 273.9 | −1.1 | 231.4 | 287.0 | −0.5e | 245.9 | 288.7 | −0.7 | 218.2 | 272.9 | −1.2 | 192.9 | 247.8 | −1.6 |
| Intercourse | |||||||||||||||
| Male | 64.4 | 83.8 | −2.6 | 65.7 | 84.9 | −2.2 | 73.6 | 92.7 | −2.2 | 70.4 | 92.3 | −2.7 | 45.0 | 60.4 | −3.3 |
| Feminine | 53.0 | 64.4 | −1.0 | 57.3 | 69.8 | −0.6 | 62.2 | 72.0 | −0.4 | 54.2 | 65.4 | −0.9 | 39.2 | 50.7 | −1.9 |
| Race and ethnicity | |||||||||||||||
| NH White | 63.2 | 78.2 | −1.6 | 65.5 | 80.8 | −1.2 | 69.2 | 82.7 | −1.1 | 68.0 | 84.1 | −1.6 | 45.9 | 60.2 | −2.6 |
| NH Black | 58.6 | 76.5 | −2.3 | 52.1 | 71.5 | −2.7 | 72.6 | 92.2 | −2.0 | 58.1 | 74.9 | −2.1 | 50.0 | 67.1 | −3.1 |
| NH API | 36.0 | 44.7 | −1.0 | 39.1 | 48.9 | 0.3e | 35.8 | 40.1 | −1.3 | 29.8 | 37.7 | −1.2 | 37.4 | 46.3 | −1.3 |
| NH AIANf | 53.8 | 68.7 | −2.1 | 66.2 | 81.8 | −1.3 | 73.7 | 88.0 | −1.0 | 57.8 | 73.3 | −1.7 | 43.8 | 58.0 | −2.7 |
| Hispanic | 28.7 | 37.0 | −1.8 | 36.0 | 46.4 | −1.2 | 32.2 | 38.1 | −2.2 | 29.3 | 37.1 | −1.7 | 24.6 | 33.2 | −2.1 |
| Stage at prognosisg | |||||||||||||||
| Localized solely | 15.7 | 16.9 | 2.8 | 18.2 | 19.1 | 4.0 | 18.1 | 18.5 | 3.6 | 15.8 | 17.4 | 1.8 | 11.2 | 12.7 | 2.0 |
| Regional | 13.2 | 17.4 | −2.2 | 13.4 | 18.1 | −2.1 | 16.0 | 19.7 | −1.5 | 14.2 | 18.8 | −2.3 | 8.7 | 12.2 | −3.2 |
| Distant | 27.1 | 36.1 | −3.6 | 27.6 | 37.0 | −3.6 | 31.4 | 40.8 | −3.4 | 28.7 | 37.8 | −3.3 | 20.3 | 27.7 | −4.3 |
| Unknown | 2.0 | 2.5 | −1.4 | 1.5 | 1.8 | −2.2e | 1.7 | 1.9 | 2.0 | 2.6 | 3.2 | −2.0 | 1.5 | 2.3 | −2.8e |
| Localized-only stage at prognosis, by race and ethnicityh | |||||||||||||||
| NH White | 17.5 | 18.5 | 2.9 | 20.0 | 20.7 | 4.2 | 18.8 | 19.1 | 3.6 | 18.0 | 19.4 | 2.0 | 13.0 | 14.4 | 2.2 |
| NH Black | 14.0 | 15.5 | 2.3 | 13.2 | 15.3 | 2.6 | 17.5 | 19.0 | 2.9 | 13.7 | 14.3 | 2.4 | 11.4 | 13.7 | 1.8e |
| NH-API | 8.0 | 9.2 | 3.8 | 10.8 | 12.0 | 5.3 | 8.0 | 7.9 | 2.1e | 6.1 | 7.3 | 3.9e | 7.7 | 9.0 | 3.0 |
| NH-AIANf | 14.8 | 16.2 | 2.6 | 21.5 | 22.3 | 3.9 | 19.7 | 19.8 | 3.9 | 14.3 | 16.2 | 2.1 | 11.8 | 13.5 | 1.8 |
| Hispanic | 6.9 | 7.9 | 2.5 | 9.8 | 11.0 | 3.7 | 7.5 | 7.8 | 2.5e | 6.6 | 7.8 | 2.4 | 5.8 | 6.7 | 1.8e |
Abbreviations: AAPC, common annual % change; AIAN, American Indian or Alaska Native; API, Asian or Pacific Islander; NH, non-Hispanic.
a Incidence charges calculated per 100,000 individuals, age-adjusted to the 2000 US customary inhabitants.
b 2020 Single-year incidence charges exclude knowledge from Nevada and Indiana.
c 10-12 months incidence fee makes use of knowledge from 2010–2019.
d AAPC in incidence fee from 2010–2019, calculated utilizing Joinpoint Regression Program; measures of pattern (AAPC) have been calculated utilizing knowledge years 2010–2019 solely.
e Denotes calculated AAPCs that aren’t statistically completely different from 0% at significance degree of P < .05.
f NH-AIAN populations have been restricted to people residing in bought or referred care supply areas (12).
g Outlined by Merged Abstract Stage (11).
h Age-adjusted incidence charges of lung cancers recognized at localized-only stage, stratified by race and ethnicity.
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