Global, regional, and national trends in burden of lung cancer and chronic obstructive pulmonary disease and associated risk factors, 1990-2021: results from the global burden of disease study 2021.

BACKGROUND

Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are fatal respiratory diseases with shared pathophysiological mechanisms. However, their global burden patterns remain insufficiently characterized within a comparative framework. This study aimed to conduct a comprehensive comparative global burden analysis of LC and COPD.

METHODS

Using Global Burden of Disease (GBD) study data(1990-2021), we analyzed LC and COPD burden (incidence, prevalence, mortality, and disability-adjusted life years (DALYs)), identified their associated risk factors, elucidated temporal trends, and projected future burden from 2022 to 2050.

RESULTS

In 2021, significant geographical variations in the burden of LC and COPD were observed, with LC predominantly burdening high-income European and Oceanian regions and COPD concentrated in low-to-middle-income Asian and Oceanian countries. Ten shared risk factors were identified for both diseases, among which tobacco use, smoking, ambient and household air pollution, occupational carcinogen exposure, and particulate matter pollution were the most common and prominent. Demographically, both diseases were concentrated in the elderly, peaking at slightly older ages, with LC showing more pronounced male predominance than COPD. From 1990-2021, females LC burden, rost most regions,whereas COPD burden declined globally across genders. Socioeconomically, socio-demographic index (SDI) was positively correlated with LC burden, but negatively correlated with COPD mortality and disability. High-SDI regions experienced a decline in LC and COPD declines, contrasting with the rising COPD prevalence in low-to-middle SDI regions. Projections (2022-2050) indicate declining LC incidence, mortality, and DALY rates (age-standardized incidence rate (ASIR) from 26.43 to 22.18 per 100,000 by 2050), with stable prevalence. All COPD metrics are projected to decrease (age-standardized mortality rate (ASMR) from 45.22 to 20.83 per 100,000 by 2050).

CONCLUSION

This study presented a comprehensive comparative analysis of the global burden of LC and COPD, offering descriptive and comparative epidemiological evidence to inform tailored, disease-specific and region-specific prevention and control efforts.