Demographic trends and mortality disparities in emphysema across the United States (1999-2023): a retrospective population-based study using CDC WONDER database.

Background: Emphysema is a global threat causing significant mortality and economic burden. Risk factors like smoking, secondhand smoke, vaping, and pollutants are strongly linked to the progression and mortality of emphysema. Objective: The study analyzed demographic trends and disparities in mortality rates due to emphysema among all age groups from 1999 to 2023. Methods: We used the CDC WONDER database to analyze age-adjusted mortality rates (AAMRs) for emphysema (ICD-J43 from 1999 to 2023), stratifying by year, sex, race, and census region. We calculated annual percentage changes per 100 000 with 95% confidence intervals using Joinpoint regression. Results: A total of 548 467 emphysema-related deaths were recorded in the United States between 1999 and 2023. National age-adjusted mortality rates (AAMRs) showed significant declines from 1999 through 2015, followed by a reversal with increasing rates through 2023. Males consistently exhibited higher mortality than females, though both experienced substantial reductions before subsequent increases in the last decade.Ethnic disparities were evident: non-Hispanics had persistently higher mortality than Hispanics, with the latter showing overall lower rates and largely sustained declines. Regional analysis revealed the Midwest as bearing the highest mortality burden, followed by the West, South, and Northeast. All regions demonstrated early declines in mortality, with later upturns emerging after 2015, most prominently in the South and West. Conclusion: This study reveals that strict antismoking campaigns and health education must be further implemented to reduce mortality rates related to emphysema. These findings emphasize the need for further targeted interventions, awareness, and improved access to care to reduce mortality from emphysema.