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Racial/Ethnic Disparities and Geographic Differences in Lung Cancer Incidence—38 States and the District of Columbia, 1998–2006

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November 12, 2010 / Vol. 59 / No. 44

MMWR Highlights

Lung Cancer Incidence

  • Race
    During 1998–2006, annual incidence of lung cancer was highest among blacks, followed by whites, American Indians/Alaska Natives, and Asian/Pacific Islanders.
    • 76.1 per 100,000 among blacks
    • 69.7 per 100,000 among whites
    • 48.4 per 100,000 among American Indians/Alaska Natives
    • 38.4 per 100,000 among Asian/Pacific Islanders
  • Ethnicity
    During 1998–2006, Hispanics had lower lung cancer incidence than non-Hispanics.
    • 37.3 per 100,000 among Hispanics
    • 71.9 per 100,000 among non-Hispanics
  • Age
    During 1998–2006, annual incidence of lung cancer varied greatly with age, peaking among people aged 70–79 years.
    • 0.9 per 100,000 among people aged 39 or younger
    • 21.8 per 100,000 among people aged 40–49 years
    • 86.5 per 100,000 among people aged 50–59 years
    • 258.0 per 100,000 among people aged 60–69 years
    • 354.8 per 100,000 among people aged 80 years or older
    • 462.7 per 100,000 among people aged 70–79 years
  • Sex
    During 1998–2006, females had lower lung cancer incidence than males.
    • 55.4 per 100,000 among females
    • 88.2 per 100,000 among males
  • Region
    During 1998–2006, annual incidence of lung cancer was highest in the South, followed by the Midwest, Northeast, and West.
    • 76.0 per 100,000 in the South
    • 73.0 per 100,000 in the Midwest
    • 68.6 per 100,000 in the Northeast
    • 58.8 per 100,000 in the West

Lung Cancer and Cigarette Smoking

  • Racial/ethnic disparities in lung cancer incidence are associated with multiple factors, including differences in smoking prevalence, metabolism of tobacco smoke products, and susceptibility to tobacco-induced lung cancer.
  • The observed variation in lung cancer incidence by region parallels a reported variation in smoking prevalence across the United States, including higher smoking rates in the South and Midwest and lower rates in the West. Regional differences in smoking prevalence exist by race/ethnicity, including a higher smoking prevalence among whites in the South, blacks and Hispanics in the Midwest, and A/PIs in the West.

Tobacco Control

  • State comprehensive tobacco control programs, which aim to reduce smoking and tobacco use, can help reduce regional variation of lung cancer incidence.
  • Tobacco control efforts to prevent initiation and increase cessation have been effective in decreasing lung cancer incidence overall and in narrowing the race-based disparity among young adult smokers (i.e., people aged 20–39 years).
  • Smoking cessation counseling interventions (e.g., quitlines) and medications have been found to be effective cessation interventions in these various populations.
  • CDC recommends a comprehensive approach to tobacco control, including evidence-based tobacco prevention and cessation strategies.



  • CDC analyzed data collected by CDC's National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program for the period 1998–2006.
  • These combined data reflect new lung cancer cases representing approximately 80% of the U.S. population.