Smoking and Lung Cancer Mortality in the United States From 2015 to 2065

Abstract

Background: Tobacco control efforts implemented since the 1960s in the US have led to considerable reductions in smoking and smoking-related diseases including lung cancer. Objective: To project the reduction in tobacco use and lung cancer mortality due to existing tobacco control efforts from 2015 to 2065. Design: Comparative modeling approach using four lung cancer natural history simulation models that explicitly relate temporal smoking patterns to lung cancer rates. Setting: US population, 1964–2065. Participants: Adults ages 30–84. Measurements: Models were developed using US smoking (1964–2015) and lung cancer mortality (1969–2010) data. Each model projected lung cancer mortality by smoking status assuming current declines in smoking continue into the future. Sensitivity analyses were conducted comparing optimistic and pessimistic assumptions relative to the status quo. Results: Under the status quo scenario, age-adjusted lung cancer mortality is projected to drop 79% from 2015 to 2065. Concomitantly, and despite the expected US population growth, aging and longer life expectancy, the annual number of lung cancer deaths is projected to decrease from 135,000 to 50,000 (63% reduction). Nonetheless, 4.4 million deaths from lung cancer are still projected to occur in the US from 2015–2065, with about 20 million adults of ages 30–84 continuing to smoke in 2065. Limitations: Projections assume that under the status quo, there are no changes to tobacco control efforts in the future, and do not explicitly consider the potential impact of lung cancer screening. Conclusion: Tobacco control efforts since the 1960’s will continue to reduce lung cancer rates well into the next half century. Additional prevention and cessation efforts are required to sustain and expand these gains, and further reduce the lung cancer burden in the US.

Cancer statistics, 2019

“…There were approximately 20% more lung cancer deaths in men (80,775) than in women (68,095) in 2016, but this pattern is projected to reverse by 2045 if current smoking trends continue. 67 Cervical cancer continues to be the second leading cause of cancer death in women aged 20 to 39 years, causing 9 deaths per week in this age group. This finding underscores the need for increased HPV vaccination uptake in adolescents and guideline-adherent screening in young women.…”

Area Deprivation Index and Rurality in Relation to Lung Cancer Prevalence and Mortality in a Rural State

“…Rural communities are experiencing growing disparities in smoking rates among adults ( 5 ) and youth ( 26 ) that have been driven by more rapid declines in smoking among residents of urban places. Programs to control tobacco that are already implemented are projected to reduce lung cancer rates going forward ( 27 ). However, a detailed review of tobacco prevention and control in the United States suggests that rural residents are more likely to live in states with fewer prevention policies and in communities without robust local tobacco-control provisions ( 28 ).…”

Trends and Patterns of Disparities in Burden of Lung Cancer in the United States, 1974-2015

“…This has been associated with the later uptake of smoking cessation among females (31), lower female cessation rates (32), and large variations in the level of tobacco control across states in the US (33). Convergence in smoking behaviors between males and females led to the diminishing gender gap in lung cancer mortality, which is expected to close circa 2,045 (34). The trend of lung cancer among young adults is a sentinel measure of the effectiveness of tobacco control programs (35).…”

“…The trend of lung cancer among young adults is a sentinel measure of the effectiveness of tobacco control programs (35). Although the trend among the young population is unlikely to substantially affect the status quo epidemiological profile of lung cancer, due to its relatively small fraction, it could considerably impact the lung cancer burden and other smoking-related diseases 30 years later, as this cohort ages (34).…”