Age-adjusted mortality for acute respiratory failure in lung cancer increased from 6.13 in 1999 to 47.59 per 1,000,000 in 2023, with higher burdens in males and Non-Hispanic Black individuals.
Observational (n=118,640)
Yes
Mortality associated with acute respiratory failure in lung cancer has markedly increased over the past 25 years in the US, with disproportionate burdens among males, Non-Hispanic Black individuals, and residents of the Midwest and non-metropolitan regions.
Abstract Background Acute respiratory failure is a frequent terminal event in patients with advanced lung cancer. Understanding long-term mortality trends and demographic disparities in lung cancer deaths associated with respiratory failure is critical for developing targeted interventions and improving end-of-life care. Methods US mortality data for adults associated with Acute Respiratory Failure (J96) and Lung Cancer (C34) were analyzed, using the CDC WONDER database (1999-2023). Age-adjusted mortality rates (AAMRs) per 1,000,000 persons and Average Annual Percent Change (AAPCs) with 95% confidence intervals (CIs) were calculated using the Joinpoint Regression Model with a specific focus on sex, race, year, and geographical location. Results Between 1999 and 2023, a total of 118,640 deaths were attributed to Acute Respiratory Failure and Lung Cancer (males: 66,089; females: 52,551). Overall, the AAMR steadily increased from 6.13 in 1999 to 47.59 in 2023. Men had consistently higher AAMR than women (1999: 8.48 vs 4.52, 2023: 56.91 vs 40.18 respectively). When stratified by race, the highest overall mortality was observed among Non-Hispanic Black or African American with AAMR increasing from 7.05 in 1999 to 52.13 in 2023 (AAPC: 9.14; 95% CI: 8.27-10.21), followed by NH Whites (AAMR: 1999; 6.18 vs 2023; 51.79). Regional differences showed the Midwest with the highest AAMR (51.79) in 2023 (AAPC for 1999-2023: 9.87; 95% CI: 9.36-10.57). Mortality rates were also higher in non-metropolitan areas with AAMR 18.58 (AAPC: 9.38; 95% CI: 9.09-9.79) than in metropolitan areas with AAMR 16.2 (AAPC: 8.58; 95% CI: 8.40-8.81). Conclusion Mortality associated with acute respiratory failure in lung cancer has markedly increased over the past 25 years, with disproportionate burdens among males, Non-Hispanic Black individuals, and residents of the Midwest and non-metropolitan regions. These findings highlight the need for targeted public health initiatives and improved access to specialized palliative and pulmonary care for high-risk populations. This abstract is funded by: None
Aleem et al. (2026) conducted an observational in Acute Respiratory Failure in Lung Cancer (n=118,640). Age-adjusted mortality for acute respiratory failure in lung cancer increased from 6.13 in 1999 to 47.59 per 1,000,000 in 2023, with higher burdens in males and Non-Hispanic Black individuals.
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