Differences in Lung Cancer Survival by Demographic Characteristics and Social Determinants of Health, United States, 2010-2020

Objectives: Common data sources that examine cancer survival provide limited information on health behaviors or social determinants of health. We linked individual-level cancer registry data to county-level data to examine differences in survival among people diagnosed with lung cancer. Methods: We linked 2010-2020 National Program of Cancer Registries survival data from 40 registries, covering 85% of the US population, to county-level data on current age-adjusted cigarette smoking prevalence, average daily density of fine particulate matter (PM 2.5 ) in µg/m 3 (fine particulate pollution), and overall social vulnerability. We generated Kaplan–Meier survival curves and used multivariable Cox proportional hazards regression to examine overall and cause-specific survival among people aged ≥20 years diagnosed with lung cancer. Results: Survival was significantly lower among people who lived in counties with a higher prevalence of cigarette smoking of 14.3% to