{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:50:14Z","timestamp":1789062614926,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lung cancer (LC) is a major cause of secondary brain metastasis (SBM); however, mortality patterns associated with these conditions among older adults in the United States remain understudied. This study aimed to investigate trends in age\u2010adjusted mortality rates (AAMRs) and identify demographic and geographical disparities from 1999 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross\u2010sectional analysis used death certificate data from the US Centers for Disease Control and Prevention Wide\u2010Ranging Online Data for Epidemiologic Research (CDC WONDER) database, spanning 1999\u20132020. The study focused on older adults (\u2265\u00a065 years), identifying cases where LC and SBM were recorded as either the underlying or contributing causes of death. AAMRs per 100,000 people, and annual percent changes (APCs) were calculated. Trends were analyzed by year, sex, race\/ethnicity, and geographical region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall AAMR dropped between 1999 and 2013, increased steadily until 2017 (APC:3.4; 95% CI: \u22121.25 to 5.4), and then stabilized until 2020. Men had higher AAMRs (14.3) compared to women (10.0). Among racial\/ethnic groups, non\u2010Hispanic (NH) Whites (12.7) and NH Blacks (11.7) had the highest AAMRs. Most patients died at home (44.5%). Geographically, the Midwest (13.0) and rural areas (11.4) showed higher mortality, highlighting notable disparities. States with LC\u2010 and SBM\u2010related mortality rates in the 90th percentile included Arkansas, Mississippi, Vermont, Indiana, and West Virginia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following an initial decline, mortality has risen again in recent years. Considerable disparities were noted among various demographics and regions. Equitable efforts, including early diagnosis and management, are essential to reduce the burden on high\u2010risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71377","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:37:41Z","timestamp":1775018261000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Mortality Related to Lung Cancer and Secondary Brain Metastasis Among Older Adults in the United States From 1999 to 2020; Insights From CDC\u2010WONDER"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5549-7988","authenticated-orcid":false,"given":"Muhammad Haleem","family":"Nasar","sequence":"first","affiliation":[{"name":"Department of Medicine Northwest School of Medicine  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eeshal","family":"Fatima","sequence":"additional","affiliation":[{"name":"Department of Medicine Services Institute of Medical Sciences  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Ahad","sequence":"additional","affiliation":[{"name":"Department of Medicine Naseer Teaching Hospital Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehar Ul","family":"Duaa","sequence":"additional","affiliation":[{"name":"Department of Medicine Services Institute of Medical Sciences  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wania","family":"Sultan","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow Medical College Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumail Mustafa","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine Jinnah Sindh Medical University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4664-591X","authenticated-orcid":false,"given":"Asad Ali Ahmed","family":"Cheema","sequence":"additional","affiliation":[{"name":"Department of Medicine International School of Medicine International University of Kyrgyzstan  Bishkek Kyrgyzstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik W. Z.","family":"Khan","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Hashim Ali","family":"Inam","sequence":"additional","affiliation":[{"name":"Department of Neurology Marshall University Neuroscience  Huntington West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Khyber Teaching Hospital  Peshawar Pakistan"},{"name":"Institute of Public Health and Social Sciences Khyber Medical University  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Department of Neurology Marshall University Neuroscience  Huntington West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2024.200353"},{"key":"e_1_2_12_3_1","unstructured":"American Cancer Society. \u201cKey Statistics for Lung Cancer: How Common is Lung Cancer?.\u201d Last modified January 13 2026.https:\/\/www.cancer.org\/cancer\/types\/lung\u2010cancer\/about\/key\u2010statistics.html."},{"key":"e_1_2_12_4_1","unstructured":"American Cancer Society.2024. \u201cAmerican Cancer Society Releases Latest Global Cancer Statistics; Cancer Cases Expected to Rise to 35 Million Worldwide by 2050.\u201d Published April 4.https:\/\/pressroom.cancer.org\/GlobalCancerStatistics2024."},{"key":"e_1_2_12_5_1","unstructured":"American Lung Association.2023.State of Lung Cancer 2023.American Lung Association.https:\/\/www.lung.org\/getmedia\/186786b6\u201018c3\u201046a9\u2010a7e7\u2010810f3ce4deda\/SOLC\u20102023\u2010Print\u2010Report.pdf."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.7624"},{"key":"e_1_2_12_7_1","unstructured":"Centers for Disease Control and Prevention. n.d. \u201cNational Center for Health Statistics Mortality Data on CDC WONDER.\u201d Accessed November 4 2024.https:\/\/wonder.cdc.gov\/mcd.html."},{"key":"e_1_2_12_8_1","unstructured":"Centers for Disease Control and Prevention. n.d. \u201cMultiple Cause of Death 1999\u20132020.\u201dhttps:\/\/wonder.cdc.gov\/wonder\/help\/mcd.html?msclkid=8c86c6c2b06511ec84708c2386801f7f#:~:text=than%2010%20persons.\u2010 See%20Assurance%20of%20Confidentiality%20for%20more%20information."},{"key":"e_1_2_12_9_1","unstructured":"Centers for Disease Control and Prevention.2025. \u201cHealth United States: Cause of Death.\u201d Published June 9.https:\/\/www.cdc.gov\/nchs\/hus\/sources\u2010definitions\/cause\u2010of\u2010death.htm#:~:text=For%20national%20mortality%20statistics%2C%20every revision%20(ICD%E2%80%939)."},{"issue":"38","key":"e_1_2_12_10_1","first-page":"1305","article-title":"Current Cigarette Smoking Prevalence Among Working Adults\u2013United States, 2004\u20132010","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"issue":"44","key":"e_1_2_12_11_1","first-page":"889","article-title":"Current Cigarette Smoking Among Adults\u2014United States, 2011","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29110660"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics16020245"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.7826"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16091771"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.2307\/2136508"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2024.101438"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758834014521110"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.7004"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2008.05.019"},{"key":"e_1_2_12_22_1","volume-title":"Hispanic Paradox","author":"Elsevier"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615\u2010025\u201002349\u20101"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2017.1361960"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000146"},{"key":"e_1_2_12_26_1","first-page":"1","article-title":"Reducing Racial and Ethnic Disparities in Access to Care: Has the Affordable Care Act Made a Difference?","volume":"2017","author":"Hayes S. 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