Worldwide burden and epidemiological trends of tracheal, bronchus, and lung cancer: A population-based study

Abstract

Background: We comprehensively analyzed the global burdens and trends in incidence and mortality of tracheal, bronchus, and lung (TBL) cancer among subgroups of distinctive ages and genders.

Methods: We retrieved incidence and mortality rates of lung cancer in 2020 from the GLOBOCAN database among 185 countries. The incidence and mortality age-standardized rates (ASRs) were mostly obtained from Cancer Incidence in Five Continents and World Health Organization mortality database, respectively. The joinpoint regression analysis has been conducted to evaluate the average annual percentage change of incidence and mortality in recent years.

Findings: Trends in the incidence and mortality were decreasing among men in most countries, whereas the trends were increasing among women in some regions. As for mortality, most countries had a decreasing trend in mortality among males, but increasing trends were observed in more than half of countries among females. Furthermore, the majority of countries showed a significant decrease in incidence among males (AAPCs, -0·34 to -6·53), whereas most countries had a significant increase among females (AAPCs, 9·39 to 0·6), especially in European countries. In addition, a more drastic decrease was identified in the trends of the incidence among young people. 33 countries had a drastic decrease among males, especially in countries in Europe (AAPCs, -0·93 to -11·71). And 15 countries showed a significant decrease in incidence among young women (AAPCs, -0·94 to -9·35).

Interpretation: Decreasing incidence and mortality trends were identified in TBL cancer, particularly among all-age men and women younger than 50 years old. But some other groups of individuals showed an opposite trend, such as women in European countries. More preventive interventions are required for the specific populations.

Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Keywords: ASR; Epidemiology; Global; Lung cancer; Trend analysis.

Figure 1

The global estimated incidence and mortality of lung cancer in 2020, both sexes, all ages. The map was produced by the International Agency for Research on Cancer (IARC) and World Health Organization (WHO). The materials and names provided in this study do not represent any opinion of WHO or IARC regarding the legal status of any country, territory, city or region or its authorities or the delimitation of its borders. Dashed lines were used to characterize approximate borderlines that may not yet be full agreement.

Figure 2

Temporal trends in incidence and mortality of tracheal, bronchus, and lung cancer by country or population in males and females. The dark red lines denote the mortality for males, the light red lines denote the mortality for females. The dark blue lines denote the incidence for males, the light blue lines denote the incidence for females.

Figure 3

The average annual percentage change (AAPC) of the mortality of tracheal, bronchus, and lung cancer in all-age men and women. The AAPC is denoted by the coloured bars and 95% confidence intervals (CIs) are represented by error bars. The permutation test is applied for testing between two different joinpoint models. *Subnational data.

Figure 4

The average annual percentage change (AAPC) of the incidence of tracheal, bronchus, and lung cancer in all-age men and women. The AAPC is denoted by the coloured bars and 95% confidence intervals (CIs) are represented by error bars. The permutation test is applied for testing between two different joinpoint models. *Subnational data.

Figure 5

The age standardized rate at the start of each study period versus average annual percentage change during the recent 10 years for tracheal, bronchus, and lung cancer. The red bubbles denote the mortality and the blue bubbles denote the incidence. The red and blue deepen as the human development index (HDI) increases.