Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019
Authors: Hedyeh Ebrahimi, Zahra Aryan, Sahar Saeedi Moghaddam, Catherine Bisignano, Shahabeddin Rezaei, Farhad Pishgar, Lisa M Force, Hassan Abolhassani, Eman Abu-Gharbieh, Shailesh M Advani, Sohail Ahmad, Fares Alahdab, Vahid Alipour, Syed Mohamed Aljunid, Saeed Amini, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Jalal Arabloo, Morteza Arab-Zozani, Malke Asaad, Marcel Ausloos, Atalel Fentahun Awedew, Atif Amin Baig, Ali Bijani, Antonio Biondi, Tone Bjørge, Dejana Braithwaite, Michael Brauer, Hermann Brenner, Maria Teresa Bustamante-Teixeira, Zahid A Butt, Giulia Carreras, Carlos A Castañeda-Orjuela, Odgerel Chimed-Ochir, Dinh-Toi Chu, Michael T Chung, Aaron J Cohen, Kelly Compton, Baye Dagnew, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Frances E Dean, Meseret Derbew Molla, Abebaw Alemayehu Desta, Tim Robert Driscoll, Emerito Jose A Faraon, Pawan Sirwan Faris, Irina Filip, Florian Fischer, Weijia Fu, Silvano Gallus, Birhan Gebresillassie Gebregiorgis, Ahmad Ghashghaee, Mahaveer Golechha, Kebebe Bekele Gonfa, Giuseppe Gorini, Bárbara Niegia Garcia Goulart, Maximiliano Ribeiro Guerra, Nima Hafezi-Nejad, Samer Hamidi, Simon I Hay, Claudiu Herteliu, Chi Linh Hoang, Nobuyuki Horita, Mihaela Hostiuc, Mowafa Househ, Ivo Iavicoli, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Farhad Islami, Ashwin Kamath, Supreet Kaur, Rovshan Khalilov, Ejaz Ahmad Khan, Jonathan M Kocarnik, Burcu Kucuk Bicer, G Anil Kumar, Carlo La Vecchia, Qing Lan, Iván Landires, Savita Lasrado, Paolo Lauriola, Elvynna Leong, Bingyu Li, Stephen S Lim, Alan D Lopez, Azeem Majeed, Reza Malekzadeh, Navid Manafi, Ritesh G Menezes, Tomasz Miazgowski, Sanjeev Misra, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Ali H Mokdad, Alex Molassiotis, Lorenzo Monasta, Rahmatollah Moradzadeh, Lidia Morawska, Joana Morgado-da-Costa, Shane Douglas Morrison, Mukhammad David Naimzada, Javad Nazari, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Rajan Nikbakhsh, Virginia Nuñez-Samudio, Andrew T Olagunju, Nikita Otstavnov, Stanislav S Otstavnov, Mahesh P A, Adrian Pana, Eun-Kee Park, Faheem Hyder Pottoo, Akram Pourshams, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Alireza Rafiei, Muhammad Aziz Rahman, Pradhum Ram, Priya Rathi, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Nicholas L S Roberts, Thomas J Roberts, Luca Ronfani, Gholamreza Roshandel, Abdallah M Samy, Milena M Santric-Milicevic, Brijesh Sathian, Ione Jayce Ceola Schneider, Mario Sekerija, Sadaf G Sepanlou, Feng Sha, Masood Ali Shaikh, Rajesh Sharma, Aziz Sheikh, Sara Sheikhbahaei, Sudeep K Siddappa Malleshappa, Jasvinder A Singh, Freddy Sitas, Emma Elizabeth Spurlock, Paschalis Steiropoulos, Rafael Tabarés-Seisdedos, Eyayou Girma Tadesse, Ken Takahashi, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Ravensara S Travillian, Marco Vacante, Paul J Villeneuve, Francesco S Violante, Zabihollah Yousefi, Deniz Yuce, Vesna Zadnik, Maryam Zamanian, Kazem Zendehdel, Jianrong Zhang, Zhi-Jiang Zhang, Farshad Farzadfar, Christopher J L Murray, Mohsen Naghavi
Journal: The Lancet Respiratory Medicine (2021)

BackgroundPrevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)—a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019.MethodsBased on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010–19 period.FindingsGlobally, there were 2·26 million (95% uncertainty interval 2·07 to 2·45) new cases of tracheal, bronchus, and lung cancer, and 2·04 million (1·88 to 2·19) deaths and 45·9 million (42·3 to 49·3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3·26 million (3·03 to 3·51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23·3% (12·9 to 33·6) globally and the number of larynx cancer cases increased by 24·7% (16·0 to 34·1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7·4% (−16·8 to 1·6) and age-standardised incidence rates of larynx cancer decreased by 3·0% (−10·5 to 5·0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0·9% (−8·2 to 10·2) for tracheal, bronchus, and lung cancer and decreased by 0·5% (−8·4 to 8·1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64·2% (61·9–66·4) of all deaths from tracheal, bronchus, and lung cancer and 63·4% (56·3–69·3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019.InterpretationThe numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations—namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings.FundingBill & Melinda Gates Foundation.