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Global, regional, and national burden and trends of early-onset tracheal, bronchus, and lung cancer from 1990 to 2019.
Tracheal, bronchus, and lung cancer (TBL) is one of the main cancer health problems worldwide, but data on the burden and trends of early-onset tracheal, bronchus, and lung cancer (EO-TBL) are sparse. The aim of the present study was to provide the latest and the most comprehensive burden estimates of the EO-TBL cancer from 1990 to 2019.
Overall, we used data from the Global Burden of Disease (GBD) study in EO-TBL cancer from 1990 to 2019. Evaluation metrics included incidence, mortality, and disability-adjusted life years (DALYs). The joinpoint regression model was used to analyze the temporal trends. Decomposition analysis was employed to analyze the driving factors for EO-TBL cancer burden alterations. Bayesian age-period-cohort (BAPC) analysis was used to estimate trends in the next 20 years.
The global age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for EO-TBL cancer decreased significantly from 3.95 (95% uncertainty interval [UI]: 3.70-4.24), 3.41 (95% UI: 3.19-3.67), 158.68 (95% UI: 148.04-170.92) in 1990 to 2.82 (95% UI: 2.54-3.09), 2.28 (95% UI: 2.07-2.49), 106.47 (95% UI: 96.83-116.51) in 2019 with average annual percent change (AAPC) of -1.14% (95% confidence interval [CI]: -1.32 to -0.95), -1.37% (95% CI: -1.55 to -1.18), and - 1.35% (95% CI: -1.54 to -1.15) separately. The high and high-middle sociodemographic index (SDI) region had a higher burden of EO-TBL cancer but demonstrated a downward trend. The most prominent and significant upward trends were Southeast and South Asia, Africa, and women in the low SDI and low-middle SDI quintiles. At the regional and national level, there were significant positive correlations between ASDR, ASIR, ASMR, and SDI. Decomposition analysis showed that population growth and aging have driven the increase in the number of incidence, mortality, and DALYs in the global population, especially among the middle SDI quintile and the East Asia region. The BAPC results showed that ASDR, ASIR, and ASMR in women would increase but the male population remained relatively flat over the next 20 years.
Although global efforts have been the most successful and effective in reducing the burden of EO-TBL cancer over the past three decades, there was strong regional and gender heterogeneity. EO-TBL cancer need more medical attention in the lower SDI quintiles and in the female population.
Ma J
,Song YD
,Bai XM
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Epidemiological trends of tracheal, bronchus, and lung cancer at the global, regional, and national levels: a population-based study.
Deng Y
,Zhao P
,Zhou L
,Xiang D
,Hu J
,Liu Y
,Ruan J
,Ye X
,Zheng Y
,Yao J
,Zhai Z
,Wang S
,Yang S
,Wu Y
,Li N
,Xu P
,Zhang D
,Kang H
,Lyu J
,Dai Z
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《Journal of Hematology & Oncology》
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Global, regional, and national burden of tracheal, bronchus, and lung cancer and its risk factors from 1990 to 2021: findings from the global burden of disease study 2021.
Studies from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 can guide screening and prevention strategies for tracheal, bronchus, and lung (TBL) cancer. We aim to provide global, regional, and national estimates of the TBL cancer burden and its attributable risk from 1990 to 2021, including during the coronavirus disease 2019 (COVID-19) pandemic.
Incidence, age-standardised incidence rate (ASIR), deaths, age-standardised mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardised rate of DALYs (ASDR), and the burden due to risk factors associated with TBL cancer were analysed from 1990 to 2021. Trends in ASIR, ASMR, and ASDR of TBL cancer during the COVID-19 pandemic (2019-2021) were also determined. All statistical analyses were performed using Join-point software (version 4.9.1.0).
Between 1990 and 2021, the global incidence, deaths, and DALYs of TBL cancer to varying degrees. However, the ASIR (Average Annual Percent Change [AAPC], -0.3 [-0.4 to -0.2]), ASMR (AAPC, -0.5 [-0.7 to -0.4]), and ASDR (AAPC, -0.9 [-1.0 to -0.7]) all showed a decreasing trend. However, the ASIR, ASMR, and ASDR of TBL cancer in males all showed a decreasing trend from 1990 to 2021. In contrast, the ASIR and ASMR of TBL cancer in females showed an increasing trend, while the ASDR showed a relatively stable trend. During the COVID-19 pandemic, the trends for ASIR, ASMR, and ASDR remained stable across both sexes combined, females, males, five socio-demographic index (SDI) quintiles, and the 21 GBD regions. In 2021, smoking was a major risk factor for TBL cancer DALYs, but the attributable ASDR for smoking decreased from 1990 to 2021 in both sexes combined, as well as individually for males and females. Conversely, the attributable ASDR for secondhand smoke, high fasting plasma glucose and occupational exposure factors increased primarily among females. Furthermore, the attributable ASDR for ambient particulate matter pollution, household air pollution from solid fuels, and low-fruit diets increased primarily in regions with lower SDI quintiles from 1990 to 2021.
The burden attributable to TBL cancer has increased in some populations from 1990 to 2021, highlighting the importance of implementing targeted measures to mitigate this trend. No significant change in the burden of TBL cancer was observed during the COVID-19 pandemic; however, post-COVID-19 rates still require further observation.
This study was supported by National Key Research and Development Program of China (2023YFC3503300, 2023YFC3503305), and High Level Chinese Medical Hospital Promotion Project (HLCMHPP2023085, HLCMHPP2023001, HLCMHPP2023097).
Kuang Z
,Wang J
,Liu K
,Wu J
,Ge Y
,Zhu G
,Cao L
,Ma X
,Li J
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《EClinicalMedicine》
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Temporal trends of tracheal, bronchus, and lung cancer between 2010 and 2019, in Asian countries by geographical region and sociodemographic index, comparison with global data.
This study aimed to describe the trends in incidence, mortality, and burden of tracheal, bronchial and lung (TBL) cancer in Asia from 2010 through 2019 and compare with global and other continental data.
We collected TBL cancer data from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. For all locations, annual case data and age-standardized rates (ASRs) were used to investigate the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of TBL from 2010 to 2019. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied.
In 2019, more than 55% of TBL cancer cases and deaths occurred in Asian countries. A total of 57% of lung cancer patients lived in Asia and almost 60% of the global burden of lung cancer was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of TBL cancer increased over 1.34-, 1.31-, 1.31-, and 1.26-fold, in Asia. During this period, the age-standardized incidence rate (ASIR), the age-standardized death rate (ASDR), the age-standardized prevalence rate (ASPR), and the age-standardized DALYs rate (DALYs ASR) of TBL cancer decreased by 1, 3, 4, and 4%, respectively. While at the same time, the decreasing trend of these rates globally and in America and in Europe happened faster. In 2019, age-specific incidence, death, prevalence, and DALY cases of TBL cancer were peaking at 65-74, 70-74, 65-69, and 65-69 years, respectively. In 2019, the highest ASIR, ASDR, and DALYs ASR of TBL cancer was observed in East Asia countries and the highest ASPR in high-income Asia Pacific countries. Central Asia and high-income Asia Pacific countries experienced a decreasing trend in ASIR and ASDR, and the South Asia countries experienced the highest increasing trend from 2010 to 2019. ASPR only decreased in Central Asia, and DALYs ASR only increased in South Asia. In 2019, among high sociodemographic index (SDI) Asian countries, Brunei Darussalam had the highest ASIR, ASDR, and DALYs ASR and the Republic of Korea had the highest ASPR. Among high-middle SDIs, Turkey and Georgia; among middle SDIs, China and Armenia; among low-middle SDIs, Mongolia and the Democratic People's Republic of Korea had the highest ASIR, ASDR, ASPR, and DALY ASR of TBL cancer. Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of TBL cancer.
Most of the global burden of lung cancer occurs in Asian countries, and the decreasing trend of incidence, death, prevalence, and burden of this cancer in these countries is slower than in other regions. Therefore, the implementation of necessary measures in order to reduce the process of this cancer is considered urgent.
Rezaei F
,Mazidimoradi A
,Rayatinejad A
,Allahqoli L
,Salehiniya H
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Disparities in the global burden of tracheal, bronchus, and lung cancer from 1990 to 2019.
Tracheal, bronchus, and lung (TBL) cancer imposes a high disease burden globally, and its pattern varies greatly across regions and countries. This study aimed to explore the global burden and temporal trends of TBL cancer from 1990 to 2019.
Data on incidence, mortality, and disability-adjusted life years (DALYs) metrics (number, crude rate, and age-standardized rates), and the attributable risk fraction of DALY of TBL cancer from 1990 to 2019 in 21 Global Burden of Disease (GBD) regions, four World Bank income regions, 204 countries and territories, and the globe were obtained from the up-to-date GBD 2019 study. We applied estimated annual percentage changes (EAPCs) to the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) to quantify the temporal trends of the TBL cancer burden from 1990-2019. Associations of EAPC of age-standardized rates with universal health coverage (UHC) index at the national level were evaluated with Pearson correlation analysis.
Globally, approximately 2,260,000 new TBL cancer cases, 2,042,600 deaths, and 45,858,000 DALYs were reported in 2019. Combination of all modifiable risk factors, behavioral, environmental, and metabolic risk factors accounted for 79.1%, 66.4%, 33.3%, and 7.9% of global lung cancer DALYs, respectively. The overall ASIR (EAPC: -0.1 [95% confidence interval [CI]: -0.2, -0.1]), ASMR (EAPC: -0.3 [95% CI: -0.4, -0.3]), and ASDR (EAPC: -0.7 [95% CI: -0.7, -0.6]) decreased from 1990 to 2019. The highest mortality rate of TBL cancer occurred in the >85-year-old age group for both sexes among high-income countries (HICs) and upper-middle-income countries (UMCs), and in males aged 80-84 years and females aged >85 years in lower middle-income countries (LMCs). HICs experienced the largest declines in ASIR (-12.6%), ASMR (-20.3%), and ASDR (-27.8%) of TBL cancer between 1990 and 2019, while UMCs had the highest increases in ASIR (16.7%) and ASMR (8.0%) over the period. Eleven (52.4%), 14 (66.7%), and 15 (71.4%) regions of the 21 GBD regions experienced descending trends in ASIR, ASMR, and ASDR of TBL cancer between 1990 and 2019, respectively, with the greatest mean decrease per year (EAPC: -1.7 [95% CI: -2.0, -1.5] for ASIR, -1.9 [95% CI: -2.2, -1.7] for ASMR, and -2.2 [95% CI: -2.5, -2.0] for ASDR) being observed in eastern Europe. The ASIR, ASMR, and ASDR of TBL cancer were deemed to be in decreasing trends in 85, 91, and 104 countries and territories, with the largest decrease in Bahrain (EAPC: -3.0 [95% CI: -3.3, -2.7] for ASIR, -3.0 [95% CI: -3.3, -2.6] for ASMR, and -3.4 [95% CI: -3.8, -3.1] for ASDR). ASIR (r=0.524), ASMR (r=0.411), and ASDR (r=0.353) of TBL cancer were positively associated with UHC index at the national level in 2019.
The TBL cancer burden shows a downward trend at the global level but varies greatly across regions and countries. A decreasing trend in the TBL cancer burden was observed in the most of the 21 GBD regions and 204 countries from 1990 to 2019. UMCs had the highest burden of TBL cancer and showed the largest increases in ASIR and ASMR.
Wang C
,Wu Z
,Xu Y
,Zheng Y
,Luo Z
,Cao W
,Wang F
,Dong X
,Qin C
,Zhao L
,Xia C
,Tan F
,Chen W
,Li N
,He J
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