Journal of thoracic disease · 2025
Aging population of tracheal, bronchus, and lung cancer: global, regional, and national burden-insights from the Global Burden of Disease Study 2021.
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Liu Yuan, Zheng Jinxin, Zhang Yi, Pan Tao, Wang Yuming, Liu Qi, Wang Ziang, He Qining, Yang Yunhai, Zhang Hui, Kan Chan Siang, Liu Ruijun, Song Liwei
Аннотация
BACKGROUND: Tracheal, bronchus, and lung (TBL) cancer is the leading cause of cancer-related deaths globally and accounts for the highest incidence among all cancers. We used the Global Burden of Disease (GBD) data from 1990 to 2021 to analyze the burden of TBL cancer by age, sex, and socio-demographic index (SDI) to provide new insights.
METHODS: We utilized GBD 2021 methodologies to calculate the percentage change (PC) in TBL cancer age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and disability-adjusted life-years (DALYs). Age-period-cohort models predicted TBL cancer incidence and mortality trends for 2035. The elderly population (EP) was stratified as <70 vs. ≥70 years.
RESULTS: In 2021, TBL cancer accounted for 2.28 million [95% uncertainty interval (UI): 2.06-2.51] new cases, 2.04 million (95% UI: 1.88-2.19) deaths, and 45.9 million (95% UI: 42.3-49.3) DALYs. ASIR in males declined significantly (PC =-11.2%, 95% UI: -21.7% to -0.4%), while it slightly increased in females (PC =0.9%, 95% UI: -8.3% to 11.4%). Non-elderly (<70 years) and elderly (≥70 years) populations each contributed around 1.1 million cases, but ASIR was markedly higher in the elderly (225.78 vs. 15.74 per 100,000). Mortality among elderly males declined in some regions, while mortality among females, especially in low-SDI countries, showed no improvement and sometimes increased. Projections to 2035 suggest that ASIR and ASMR will continue rising in older women while declining in males.
CONCLUSIONS: The burden of TBL cancer is projected to rise with population aging, particularly among women. The increasing ASIR and ASMR in females warrant urgent investigation of risk factors and targeted preventive measures to curb this trend.
METHODS: We utilized GBD 2021 methodologies to calculate the percentage change (PC) in TBL cancer age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and disability-adjusted life-years (DALYs). Age-period-cohort models predicted TBL cancer incidence and mortality trends for 2035. The elderly population (EP) was stratified as <70 vs. ≥70 years.
RESULTS: In 2021, TBL cancer accounted for 2.28 million [95% uncertainty interval (UI): 2.06-2.51] new cases, 2.04 million (95% UI: 1.88-2.19) deaths, and 45.9 million (95% UI: 42.3-49.3) DALYs. ASIR in males declined significantly (PC =-11.2%, 95% UI: -21.7% to -0.4%), while it slightly increased in females (PC =0.9%, 95% UI: -8.3% to 11.4%). Non-elderly (<70 years) and elderly (≥70 years) populations each contributed around 1.1 million cases, but ASIR was markedly higher in the elderly (225.78 vs. 15.74 per 100,000). Mortality among elderly males declined in some regions, while mortality among females, especially in low-SDI countries, showed no improvement and sometimes increased. Projections to 2035 suggest that ASIR and ASMR will continue rising in older women while declining in males.
CONCLUSIONS: The burden of TBL cancer is projected to rise with population aging, particularly among women. The increasing ASIR and ASMR in females warrant urgent investigation of risk factors and targeted preventive measures to curb this trend.