Burden of mortality due to brain metastases secondary to lung cancer in the United States: A population-based study.

2021 Background: Brain metastasis is a common and severe complication in lung cancer, contributing significantly to morbidity and mortality. Despite therapeutic advances, the burden remains substantial. This study examines mortality trends, disparities, and geographic variation using CDC WONDER data in the United States. Methods: We accessed the CDC WONDER Multiple Cause of Death database (1999–2023) to identify individuals who died of brain metastasis (ICD-10: C79.3) among lung cancer patients (ICD-10: C34.0–C34.9). Mortality disparities were examined by year, sex, race/ethnicity, and geography. Age-adjusted mortality rate (AAMR) per 100,000 was calculated. Joinpoint regression was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC), with 95% confidence intervals (CIs). Results: The total of 207,151 deaths related to brain metastasis among lung cancer patients. Overall, the AAMR slightly decreased from 4.95 (95% CI: 4.85-5.05) in 1999 to 3.62 (95% CI: 3.55-3.69) in 2023 (AAPC: -1.40; 95% CI: -1.82 to -0.99, p < 0.000001). The trend initially declined, followed by an upward trajectory between 2013 and 2017 (APC: 3.03; 95% CI: 1.00 to 5.10), after which it remained relatively stable till the end of the study period (APC: 0.33; 95% CI: -0.29 to 0.95). The decrease in mortality was slightly more pronounced in men than in women (AAPC: -2.03 vs -0.74). The highest incidence rates were noted among non-Hispanic (NH) Whites, followed by NH Blacks or African Americans and NH Asians and Pacific Islanders. Geographic disparities were apparent, with the South experiencing the greatest impact, while the Northeast was the least affected. Rural regions consistently showed higher AAMR compared to urban areas, while urban locations experienced a steeper decline between the two (AAPC: -1.95 vs -0.92). Conclusions: Mortality from brain metastasis in lung cancer patients has slightly declined over the past two decades, with greater reductions observed in men. However, persistent disparities across race, geography, and rural–urban populations underscore the urgent need for targeted interventions and equitable healthcare strategies to achieve favorable outcomes. Deaths and AAMR per 1,000,000 for trends related to lung cancer with brain metastasis, 1999 to 2023. Variable Deaths AAMR (95%CI)1999 AAMR (95% CI)2023 Overall 207,151 4.95 (4.85 to 5.05) 3.65(3.55 to 3.69) Male 108,179 6.25 (6.07 to 6.42) 3.85 (3.74 to 3.96) Female 98,972 3.98(3.85 to 4.10) 3.41(3.32 to 3.50) NH White 176,368 5.17(5.06 to 5.29) 4.05(3.96 to 4.14) NH Black 22,609 6.10(5.71 to 6.48) 3.63(3.41 to 3.85) NH Asians 5,762 2.29(1.84 to 2.73) 2.68(2.42 to 2.94) South 88,589 5.40(5.22 to 5.59) 3.94(3.82 to 4.06) Northeast 30,890 4.60(4.38 to 4.82) 2.64(2.49 to 2.78) Metro 120,044 1.51 (1.44 to 1.57) (2020)5.33(5.23 to 5.42) Non metro 27,540 1.39(1.27 to 1.52) 6.17(5.94 to 6.41)