Abstract 4851: Burden and inequality of early-onset tracheal bronchus, and lung cancer in US, China, and India: A trend and comparison analysis
Authors: Li Wenxuan , Si Guojin , Zhang Yacong , Lyu Zhangyan , Chen Kexin 
Published: March 2024

Abstract
Background: For tracheal, bronchus, and lung (TBL) cancer, the leading cause of cancer morbidity and mortality worldwide, guaranteeing quality health care for all populations is a critical component of achieving universal health coverage. Little is known about the burden and inequality of early-onset TBL cancer in countries with different economic development levels. This study aimed to compare the trends of TBL cancer burden among adults in the United States (US), China and India.
Methods: Early-onset TBL cancer age was defined as 15-49 years old. We used Joinpoint regression to evaluate the average annual percentage change (AAPC) and its 95% confidence intervals (CIs) to quantify trends in incidence, mortality, and disability-adjusted life years (DALY) based on the Global Burden of Disease 2019 database. We also used the Gini coefficient (GC) to measure the age-standardized DALY rate (ASDR) inequalities across three countries.
Results: The incidence, mortality, and DALY rates for early-onset TBL cancer among Americans. population from 1990 to 2019 declined from 7.81/105 to 4.23/105, 5.95/105 to 2.96/105, and 270.54/105 to 133.41/105, respectively. However, among the Chinese and Indian populations, the incidence (China: 5.30/105 to 7.47/105; India: 0.99/105 to 1.38/105), mortality (China: 4.73/105 to 5.82/105; India: 0.90/105 to 1.23/105) and DALY (China: 227.94/105 to 270.26/105; India: 42.89/105 to 58.64/105) rate of early-onset TBL cancer show upward trend from 1990 to 2019. The AAPC in incidence (China: 1.14, 95%CI: 0.87 to 1.40; India: 1.17, 95%CI: 0.85 to 1.49), mortality (China: 0.68, 95%CI: 0.45 to 0.91; India: 1.17, 95%CI: 0.81 to 1.52) and DALY ( China: 0.50, 95%CI: 0.18 to 0.86; India: 1.11, 95%CI: 0.78 to 1.43) rates for early-onset TBL cancer from 1990 to 2019 in both Chinese and Indian populations showed an increasing trend and the increasing trend was higher than the 50-74 age group. While the AAPC in American populations presented a decreasing trend of early-onset TBL cancer (incidence: -1.76, 95%CI: -2.14 to -1.37, mortality: -2.33, 95%CI: -2.56 to -2.10, DALY: -2.35, 95%CI: -2.59 to -2.12). The AAPC in incidence mortality and DALY rates for early-onset TBL cancer from 1990 to 2019 in both the Chinese and Indian female populations showed a higher trend than the male population. The GC value of ASDR for TBL cancer showed a downward trend, from 0.32 in 1990 to 0.24 in 2019; but for early-onset TBL cancer, it showed an upward trend, from 0.28 in 1990 to 0.31 in 2019, across three countries.
Conclusions: Compared to the US, early-onset TBL cancer burden in China and India has been rising annually. The inequality in ASDR for early-onset TBL cancer remains high across all three countries. Redistributing attention and resources to help adults in low or middle socioeconomic-level countries, especially the female population, may help hold back the expanding inequality for TBL cancer.
Citation Format: Wenxuan Li, Guojin Si, Yacong Zhang, Zhangyan Lyu, Kexin Chen. Burden and inequality of early-onset tracheal bronchus, and lung cancer in US, China, and India: A trend and comparison analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4851.