Abstract C095: County-level disparities in lung cancer mortality rates by sex for non-Hispanic Blacks and non-Hispanic Whites residing in the United States
Authors: Monestime Shanada 
Published: December 2023

Abstract
Background: Lung cancer is the deadliest cancer in the United States and mortality rates are highest for Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) individuals compared to other racial groups. Additionally, lung cancer mortality rates are higher in men compared to women. However, county-level data for lung cancer mortality rates have not been studied in NHB and NHW populations stratified by sex. Further insight into county-level data disparity rates will provide stakeholders with tailoring and prioritizing community-based interventions to reduce lung cancer mortality disparities. Methods: Data from the 2015-2019 Centers for Disease Control and Prevention, United States Cancer Statistics were used to identify counties with age-adjusted lung cancer mortality rates for NHB and NHW males and females. Comparator groups were the general population for NHB and NHW, NHB vs. NHW females, and NHB vs. NHW males. Relative risk (RR) was used to determine the disparities in mortality rates between comparator groups in each county. A chi-square test was performed to identify the p-value between comparator groups. Results: Data were available for 336 counties across 40 states in the U.S. Overall, the majority of counties (N=172) demonstrated that NHBs had higher lung cancer mortality rates compared to NHWs with a mean RR of 1.24 (1.01-2.31). However, when stratified by sex, NHW females exhibited higher lung cancer mortality rates across the majority of counties (N=225) with a mean RR of 1.38 (1.01-2.7) compared to NHB females. North Carolina (N=25) and Texas (N=10) had the most counties experiencing disparities in lung cancer mortality rates between NHW and NHB females respectively. However, Dane County, Wisconsin had the highest disparity in mortality rates for NHB females compared to NHW females, RR:2.14 (p=0.001), and Middlesex County, Massachusetts had the highest disparity in mortality rates for NHW females compared to NHB females, RR:2.7 (p=0.002). NHB males exhibited higher lung cancer mortality rates across the majority of counties (N=230) with a mean RR of 1.34 (1.01-2.73) compared to NHW males. North Carolina had the most counties experiencing disparities in lung cancer mortality rates in NHW (N=13) and NHB (N=21) males. However, the District of Columbia had the highest disparity in mortality rates for NHB males compared to NHW males, RR: 2.73 (p=0.0001), and Petersburg County, Virginia had the highest disparity in mortality rates for NHW males compared to NHB males, RR:3.18 (p=&lt;0.0001). Conclusion: Lung cancer mortality disparities are occurring throughout the United States for NHW and NHB females and males with the highest disparity in Middlesex County, Dane County, Petersburg County, and the District of Columbia respectively. However, consistent data highlighted a high prevalence of counties in North Carolina demonstrating lung cancer mortality disparities for all groups, except for NHB females. Future research and interventions are needed to understand the social and structural factors associated with mortality differences within these areas.
Citation Format: Shanada Monestime. County-level disparities in lung cancer mortality rates by sex for non-Hispanic Blacks and non-Hispanic Whites residing in the United States [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C095.