Abstract Th0022: Gender Differences in Lung Cancer Mortality Among Patients with Cardiomyopathy or Heart Failure: A 20-Year Retrospective Analysis (1999-2020)

Introduction: Lung cancer is often associated with co-morbid conditions like cardiomyopathy or heart failure (HF) with exacerbated outcomes. Gender differences in mortality among these patients remain largely unexplored.This study aims to analyze gender-specific mortality differences over two decades (1999–2020) in patients with lung cancer with underlying cardiomyopathy or HF. Methodology: Death certificate data from the CDC WONDER database (1999–2020) was analyzed for lung cancer (ICD-10 code-C34) as the underlying cause of death and cardiomyopathy (ICD-10 code I42) or HF (ICD-10 code I50) as contributing causes. Patients aged >4 5 years were stratified by gender across race, origin, state, and census region. Age-adjusted mortality rates (AAMRs), standardized to the U.S. 2000 population, and APCs with 95% Confidence Intervals (CIs) were calculated to assess gender differences using Join Point Regression. Results: Lung cancer with underlying cardiomyopathy/HF caused 98,180 deaths in adults ≥45, with an AAMR of 5.4 (95% CI: 5.3–5.4) in males and 2.7 (95% CI: 2.7–2.8) in females. Among females, a notable decline occurred from 2004 to 2014 (APC = -2.40, p = 0.0128), followed by an increase from 2014–2020 (APC =3.29, p = 0.0044).In males, an earlier inflection point signaled the end of a significant decline from 2005–2013 (APC = -3.67,p = 0.0072) and a modest rise from 2013–2020 (APC =1.33, p= 0.0120). Black males had the highest AAMR (8.3), over double that of females (3.2) in 2000. The least racial disparity was among American Indians in 2020 (4.4 males vs. 3.8 females), with females reaching the highest AAMR since 2002 (Black American females: 4.17). Hispanic males showed a significant negative APC of -4.29% (95% CI: -11.37 to -2.65, p= 0.0296) during 1999–2014, while non-Hispanic females had a steeper APC rise of 4.33% (95% CI: 2.02 to 9.28, p = 0.0096) during 2016–2020. The gender gap in AAMR is widest in Arkansas (Males:10.3, 95% CI 9.7–10.9; Females:4.5, 95% CI 4.2–4.8) and narrowest in Arizona (Males:2.3, 95% CI 2.1–2.5; Females:1.2, 95% CI 1.1–1.4). Among states, males had the highest AAMR in Arkansas, while females peaked in Kentucky (AAMR: 4.7, 95% CI 4.2–5.0). Conclusion: The analysis revealed significant gender differences in mortality rates across temporal, racial, and regional dimensions, albeit with a rising trend in both genders post-2013 inflection points. Black males had the highest AAMR, while American Indians showed minimal racial disparities.