Abstract / Summary
Abstract Background Patients with lung cancer are at increased risk of severe infection and sepsis because of tumor-related immune dysregulation, impaired pulmonary defense, and exposure to anticancer treatment. However, the long-term population-level patterns of sepsis-related mortality in this population in the United States remain poorly characterized. Methods Using the CDC WONDER Multiple Cause of Death public-use dataset, we performed a retrospective population-level analysis of sepsis-related mortality among patients with lung cancer in the United States from 1999 to 2023, stratified by sex, race and ethnicity, age, urbanization level, census region, and state. We calculated age-adjusted mortality rates (AAMRs), evaluated temporal trends using Joinpoint regression, and generated exploratory forecasts for 2024–2030 using an autoregressive integrated moving average (ARIMA) model. Results From 1999 to 2023, 94,073 sepsis-related deaths were identified among patients with lung cancer in the United States. The overall AAMR increased from 1.62 (95% CI, 1.55–1.68) in 1999 to 1.95 (95% CI, 1.90–2.01) in 2023 and peaked at 2.03 in 2016. Mortality remained consistently higher in men than in women, was highest among non-Hispanic Black individuals and lowest among Hispanic individuals, and showed marked age-related heterogeneity, with the highest crude mortality rate in those aged 75–84 years and the largest increase over time in those aged ≥ 85 years. Increases were more pronounced in rural and small to medium metropolitan areas than in large metropolitan areas. ARIMA projections suggested that mortality may remain near recent levels through 2030, with no clear evidence of a substantial decline. Conclusion From 1999 to 2023, sepsis-related mortality among patients with lung cancer in the United States showed no meaningful long-term improvement and remained characterized by marked demographic and geographic disparities. Higher mortality burdens were observed among men, non-Hispanic Black individuals, older adults, and residents of rural and other high-burden areas. These findings suggest that reducing sepsis-related mortality in this population will require stronger infection prevention, earlier recognition, and timely intervention across the continuum of lung cancer care, together with broader efforts to address disparities in healthcare resource allocation and health equity.