BACKGROUND: Lung cancer is the leading cause of cancer-related mortality in Spain. This study aims to analyze the spatiotemporal pattern of lung cancer mortality in Spain and to discuss the role of potential risk factors. METHODS: A spatiotemporal study of lung cancer mortality was conducted in Spain. Moran's I index and Local Indicators of Spatial Association (LISA) were utilized to identify spatial clustering. Bivariate spatial associations and multivariate regression models were applied to examine the association between lung cancer mortality, population density, mining activity, and average income per capita. RESULTS: A total of 81.8 % of lung cancer deaths occurred in males, though there is a rising trend in deaths among females. There are low-mortality clusters mainly concentrated in inland areas of the peninsula and in the northern half of the country, while high-mortality clusters are distributed heterogeneously and, in some regions, follow the course of the rivers. Municipal-level association analysis shows a direct relationship with population density and, among individuals aged 65 and older, with mining activity
however, it reveals an inverse relationship with average income per capita. CONCLUSION: A better understanding of the spatiotemporal behavior of lung cancer mortality and its associated risk factors could be useful for primary prevention efforts and healthcare planning.