Disproportionate burden of smoking-attributable lung cancer in African Americans

Objectives: To estimate the smoking-attributable lung cancer mortality, incidence, and healthcare costs in African Americans aged 35 or older.

Methods: Lung cancer mortality and incidence rates were estimated using the Surveillance, Epidemiology, and End Results (SEER) data.  We calculated lung cancer healthcare costs using the Medical Expenditure Panel Survey data.  Smoking-attributable lung cancer rates and costs were estimated with an epidemiological attributable risk fraction model using smoking prevalence data from the National Health Interview Surveys and relative risks data from a Cancer Prevention Study.

Results:  In 2010, smoking attributed to 16,349 lung cancer cases and 12,674 lung cancer deaths among African Americans aged 35 or older.  Smoking-attributable healthcare cost of lung cancer amounted to $1.8 billion, including $1.5 billion (84%) for men and $0.3 billion (16%) for women.  Although African American men accounted for 10.8% of all male population aged 35 or older, they disproportionately accounted for 19.1% of male smoking-attributable lung cancer healthcare costs in the US ($8.1billion).

Conclusions: The economic burden of smoking-attributable lung cancer is huge among African Americans especially for men.  Tailored tobacco control programs to African Americans are needed to reduce their disproportionate burden of lung cancer attributed to smoking.