Trends in pulmonary embolism mortality among older adults with lung cancer in the united States, 1999-2020.

The concomitant occurrence of pulmonary embolism (PE) and lung cancer (LC) poses a significant mortality risk in the United States. Though both diseases are well studied across the literature individually, their combined burden remains unexplored. To evaluate the temporal trends in PE-related mortality among US adults ≥ 65 years with lung cancer from 1999 to 2020, stratified by demographic and geographic variables, by analyzing death certificates related to PE and lung cancer from the CDC WONDER database. We queried the CDC WONDER database for mortality trend analysis with multiple causes of death, having PE and LC, both as either contributing or underlying causes of death, from 1999 to 2020. AAMRs were calculated per 1,000,000 people, stratified by sex, race, geography, and metropolitan status. AAPCs and APCs with 95% CI were evaluated through Joinpoint regression. Between 1999 and 2020, there were 32,409 deaths among adults (aged ≥ 65) with PE and LC, with the majority of fatalities manifesting in medical facilities (60.52%). The overall AAMR increased significantly from 26 (95% CI: 24.3 to 27.7) in 1999 to 41.2 (95% CI: 39.4 to 42.9) in 2020, with an AAPC of 1.92 (95% CI: 1.10 to 2.76, p < 0.001). Men had higher mortality rates with an AAMR of 44.4 (95% CI: 43.8 to 45.1) than 28.4 (95% CI: 27.9 to 28.8) in females. In race/ethnicity, NH-Blacks possessed the highest AAMRs of 44.4 (95% CI: 42.9 to 45.8) among other races. In regional stratification, the Midwest region showed the highest AAMRs of 39.3 (95% CI: 38.4 to 40.1), with the highest AAMRs of 58 (95% CI: 47.5 to 68.4) in Vermont, and non-metropolitan areas had higher AAMRs of 36.06 (95% CI: 35.1 to 37) (Graphical abstract). This study highlights the potential demographic disparities in PE and LC-related mortalities among older adults, underscoring the necessity for improved interventions, early screening, public health awareness programs, and equity in healthcare access.Clinical trial registration: Not applicable, as this is a retrospective observational study that relies on publicly available data.