Lung Cancer Disparities in the United States: The Role of Smoking, Comorbidities, Socioeconomic Status, and Regional Variation

Background Lung cancer disproportionately affects certain racial and regional populations in the United States. This study examines disparities in clinical characteristics, socioeconomic distribution, and hospital outcomes among adults hospitalized with lung cancer. Methods A retrospective analysis was performed using the National Inpatient Sample 2019–2020 (NIS). Patients with a primary lung cancer diagnosis were evaluated across racial groups and U.S. regions. Key variables included smoking status, comorbidity burden, length of stay (LOS), mortality, and total hospital charges. Results White patients demonstrated the highest smoking prevalence, whereas Black patients experienced the longest LOS. Hispanic patients incurred the highest total hospital charges. Regionally, lung cancer admissions were most common in the South, which also showed lower socioeconomic status and reduced screening access. In-hospital mortality was not significantly associated with hospital region, whereas socioeconomic status showed a graded association, with progressively lower mortality risk among patients in higher income quartiles. Conclusions Significant racial and regional disparities exist in lung cancer burden and hospital outcomes. Targeted interventions addressing socioeconomic barriers, screening inequities, and comorbidity management are needed to reduce these disparities.