ArticleJournal of the National Cancer Institute2024
Trends in smoking-attributable and smoking-unrelated lung cancer death rates in the United States, 1991-2018.
Article in Journal of the National Cancer Institute, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Body mass index and cancer survival: a meta-analysis of cohort studies.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Pooled it
- Urbanization compound pathways of global lung cancer incidence risk under proximal and distal interactions.iScience · 2026Article
- Population-level cancer trends among solid organ transplant recipients in the United States during 1995-2021.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Age at diagnosis, lifestyle factors, and risk of mortality: a city-wide cohort study of cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Affordable care act and 4-year all-cause mortality among U.S. working-age adults with or without cancer: 2000-2015.American journal of translational research · 2026Article
- Maintaining momentum: the history and future of lung cancer disparities in the United States.Frontiers in oncology · 2026Review
- Regional, demographic, and temporal trends in psychoactive substance use-related mental disorder and cancer mortality in U.S. adults: a nationwide CDC WONDER analysis (1999-2020).Frontiers in oncology · 2026Article
- Evolving Therapeutic Landscape of ROS1-Positive Non-Small Cell Lung Cancer: An Updated Review.Current oncology (Toronto, Ont.) · 2025Review
- Catching up with stagnation: cause-specific dynamics of change in life expectancy at age 65 in the United States, Canada, and Latin America, 2000-2019.The Gerontologist · 2025Observational
- Trends in influenza- and pneumonia-related mortality in lung cancer patients from 1999 to 2022: a retrospective CDC WONDER analysis.Respiratory research · 2025Article
- Urban-rural disparities in lung cancer incidence and mortality patterns in Black and White populations.Cancer · 2025Article
- A robust machine learning model based on ribosomal-subunit-derived piRNAs for diagnostic potential of nonsmall cell lung cancer across multicentre, large-scale of sequencing data.Clinical and translational medicine · 2025Article
- Reducing barriers to care in the treatment of lung cancer: a narrative review.Journal of thoracic disease · 2025Review
- Disparities in the incidence, mortality and disability-adjusted life years of 33 early-onset cancer groups globally, 2012-2021: a systematic analysis.Experimental hematology & oncology · 2025Article
- Multidimensional bioinformatics perspective on smoking-linked driver genes and immune regulatory mechanisms in non-small cell lung cancer.Journal of translational medicine · 2025Article
- Lung cancer screening in people who have never smoked: lessons from East Asia.BMJ (Clinical research ed.) · 2025Article
- Cancer situation in China: an analysis based on the global epidemiological data released in 2024.Cancer communications (London, England) · 2025Article
- The impact of behavioral and environmental factors on cancer mortality in G7 countries: a 20-year ecologic study.Frontiers in public health · 2025Article
- Estimated impact of a tobacco-elimination strategy on lung-cancer mortality in 185 countries: a population-based birth-cohort simulation study.The Lancet. Public health · 2024Article
- Lung Cancer Screening-Trends and Current Studies.Cancers · 2024Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIn the United States, lung cancer death rates have been declining for decades, primarily as a result of pronounced decreases in cigarette smoking. It is unclear, however, whether there have been similar declines in mortality rates of lung cancer unrelated to smoking. We estimated trends in US lung cancer death rates attributable and not attributable to smoking from 1991 to 2018.
methodsThe study included 30- to 79-year-olds in the National Health Interview Survey who were linked to the National Death Index, 1991-2014. Adjusted hazard ratios for smoking status and lung cancer death were estimated, and age-specific population attributable fractions were calculated. Annual population attributable fractions were multiplied by annual US national lung cancer mortality, partitioning rates into smoking-attributable and smoking-unrelated lung cancer deaths. All statistical tests were 2-sided.
resultsDuring 1991-2018, the proportion of never smokers increased among both men (35.1%-54.6%) and women (54.0%-65.4%). Compared with those who had ever smoked, those who had never smoked had 86% lower risk (hazard ratio = 0.14; 95% confidence interval [CI] = 0.12 to 0.16) of lung cancer death. The fraction of lung cancer deaths attributable to smoking decreased from 81.4% (95% CI = 78.9 to 81.4) to 74.7% (95% CI = 78.1 to 71.4). Smoking-attributable lung cancer death rates declined 2.7% per year (95% CI = ‒2.9% to ‒2.5%) and smoking-unrelated lung cancer death rates declined 1.8% per year (95% CI = ‒2.0% to ‒1.5%); these declines have accelerated in recent years.
conclusionsAn increasing proportion of lung cancer deaths are unrelated to smoking based on declines in smoking prevalence. Smoking-unrelated lung cancer death rates have declined, however, perhaps because of decreases in secondhand smoke and air pollution exposure as well as treatment improvements.
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