Disease burden of trachea, bronchus and lung cancer 1990-2021 and global trends projected to 2035

Abstract

Tracheal, bronchial, and lung cancer (TBL) is among the most common malignancies worldwide, with persistently high incidence and mortality rates, posing a significant threat to public health. However, existing studies on TBL disease burden are often limited to specific regions or short-term trends, lacking systematic and predictive analyses. This study comprehensively evaluated the global, regional, and national burden of TBL across 204 countries and territories from 1990 to 2021, utilizing predictive models to estimate trends from 2022 to 2035. This study used data from the Global Burden of Disease (GBD) 2021 database to systematically analyze the prevalence (ASPR), incidence (ASIR), mortality (ASMR), and disability-adjusted life years (DALYs) associated with TBL. Age-standardized rates (ASR) were used to quantify disease burden. Historical trends were assessed using Joinpoint regression analysis, while ARIMA and Bayesian age-period-cohort (BAPC) models were employed to predict future trends. The study also incorporated the Sociodemographic Index (SDI) to investigate the impact of socioeconomic development on TBL burden. In 2021, the global ASPR, ASIR, ASMR, and DALYs for TBL were 37.28, 26.43, 23.50, and 638.60 per 100,000 population, respectively. From 1990 to 2021, ASPR increased slightly (0.09 per 100,000), while ASIR, ASMR, and DALYs declined by 0.07, 0.15, and 0.23 per 100,000, respectively. Regionally, the highest ASPR was observed in the high-income Asia-Pacific region (69.79 per 100,000), while East Asia recorded the highest ASIR (43.41 per 100,000) and ASMR (38.53 per 100,000). Sub-Saharan Africa had the lowest burden. Gender analysis showed that males had a significantly higher TBL burden than females, but their burden declined over the study period. In contrast, females, particularly in older age groups, experienced an increase in burden. Future predictions indicate that the overall TBL burden will decline between 2022 and 2035; however, the burden among females and older adults is projected to rise, with a marked increase in female ASPR. This study highlights the global and regional trends in TBL burden from 1990 to 2021 and provides predictions for future burden. Although the overall burden is declining, significant disparities exist across genders and regions, with East Asia and high-income North America warranting particular attention. Females and older adults are priority groups for future interventions. The findings underscore the importance of early screening, targeted interventions, and region-specific strategies to optimize public health policies, resource allocation, and tailored prevention efforts.

Keywords: ARIMA; BAPC; Epidemiology; Joinpoint regression analysis; Regional disparities; TBL.

Fig. 1

Global disease burden of TBL, 1990–2021. (A) Prevalence numbers and ASPR. (B) Incidence numbers and ASIR. (C) Mortality numbers and ASMR. (D) DALYs numbers and AS-DALYs.

Fig. 2

Global distribution of TBL disease burden in 2021. (A) Age-standardized prevalence rates. (B) Age-standardized incidence rates. (C) Age-standardized mortality rates. (D) Age-standardized DALYs rates.

Fig. 3

Estimated annual ASRs for TBL from 1990–2021, combining both sexs across 204 countries. (A) ASPR, (B) ASIR, (C) ASMR, (D) AS-DALYs. DALYs, disability-adjusted life–years.

Fig. 4

Sex- and age-structured analysis of TBL disease burden in 2021. (A) Prevalence rates and numbers. (B) Incidence rates and numbers. (C) Mortality rates and numbers. (D) DALYs rates and numbers.

Fig. 5

The Joinpoint regression analysis of the TBL disease burden temporal trends, 1990–2021. (A) Age-standardized prevalence rates. (B) Age-standardized incidence rates. (C) Age-standardized mortality rates. (D) Age-standardized DALYs rates.

Fig. 6

Global temporal trends in TBL disease burden, 1990–2021. (A) Prevalence rates in all age groups. (B) Mortality rates in all age groups. (C) Incidence rates in all age groups. (D) DALYs rates in all age groups.

Fig. 7

Trends in age-group-specific prevalence and mortality rates for TBL, 1990–2021. (A) 15–19 years. (B) 80 + years. (C) 75–79 years. (D) 80 + years.

Fig. 8

Trends and correlation of ASRs with SDI from 1990–2021. (A) Trends and correlation of ASPR with SDI across 22 regions. (B) Trends and correlation of ASIR with SDI across 22 regions. (C) Trends and correlation of ASMR with SDI across 22 regions. (D) Trends and correlation of AS-DALYs with SDI across 22 regions.

Fig. 9

Projected global burden of TBL from 2022 to 2050. (A–D) Age-standardized prevalence, incidence, mortality and DALYs rates of ARIMA model. (E–H) Age-standardized prevalence, incidence, mortality and DALYs rates of BAPC model.

Fig. 10

Predictions of future trends of TBL ASPR in different age groups, 2022–2035.

Fig. 11

Predictions of future trends of TBL ASMR in different age groups, 2022–2035.