Although tracheal, bronchus, and lung cancer remained the leading cause of cancer-related mortality globally in 2019, the incidence of respiratory tract cancers and their mortality rates appear to have declined globally between 2010 and 2019—yet not in the low sociodemographic index quintile. In this population, rates of these cancers have increased, especially among women. These were among the findings of a systematic analysis of the Global Burden of Diseases, Injuries, and Risk Factor (GBD) 2019 Study  recently published in The Lancet Respiratory Medicine.

A team of investigators — the GBD 2019 Respiratory Tract Cancers Collaborators — analyzed GBD data collected from 1990 to 2019 (with an emphasis on trends from 2010 to 2019) to generate global, regional, and national estimates of the burden of tracheal, bronchus, lung, and larynx cancer, as well as their attributable risks. The researchers assessed factors related to these cancers that included mortality, incidence, years patients lived with disability, disability-adjusted life-years, and years of life lost.

Researchers also estimated to what extent each of the risk factors identified by the GBD 2019 study contributed to mortality rates for each cancer, analyzing data on risk exposure, relative risks, and the theoretical minimum risk exposure level from a total of 204 countries and territories. Data was stratified by sex and sociodemographic index.


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In 2019, a total of 2.26 million (95% CI, 2.07-2.45 million) incident cases of tracheal, bronchus, and lung cancer were reported globally, with 1.52 million cases diagnosed among males (95% CI, 1.37-1.68 million) and 737,000 diagnosed among females (95% CI, 658,000-814,000). Between 2010 and 2019, the total number of new cases of tracheal, bronchus, and lung cancer increased by 23.3% (95% CI, 12.9-33.6%).

Additionally, in 2019, a total of 2.04 million deaths (95% CI, 1.88-2.19 million), as well as 45.9 million disability-adjusted life-years (95% CI, 42.3-49.3 million), were reported globally due to tracheal, bronchus, and lung cancer. Further, in 2019, a total of 209,000 new cases of larynx cancer (95% CI, 194,000-225,000), 123,000 deaths from larynx cancer (95% CI, 115,000-133,000), and 3.26 million disability-adjusted life-years due to larynx cancer (95% CI, 3.03- 3.51 million) were reported globally.

In males, global age-standardized incidence rates of tracheal, bronchus, and lung cancer decreased by 7.4% (95% CI, –16.8 to 1.6%), and age-standardized incidence rates of larynx cancer decreased by 3.0% (95% CI, –10.5 to 5.0%), over the past decade (ie, 2010 to 2019). During the same time period, among females, age-standardized incidence rates of tracheal, bronchus, and lung cancer increased by 0.9% (95% CI,
–8.2 to 10.2%), and age-standardized incidence rates of larynx cancer decreased by 0.5% (95% CI, –8.4 to 8.1%).

Although age-standardized incidence and death rates for tracheal, bronchus, lung, and larynx cancers decreased globally in both sexes combined from 2010 to 2019, elevated rates were observed at some locales—particularly those on the lower end of the sociodemographic index range. Further, in 2019 in both sexes combined, smoking was the leading specific risk factor for age-standardized mortality from tracheal, bronchus, and lung cancer per 100,000 population in all sociodemographic index quintiles and GBD regions. Among females, however, household air pollution from solid fuels was the main specific risk factor in the low sociodemographic index quintile and in 3 GBD regions (ie, central, eastern, and western sub-Saharan Africa) in 2019.

The researchers said their analysis showed that preventive measures need to be prioritized among populations in these high-risk areas. Such preventive measures include smoking control interventions, air quality management programs focused on major sources of air pollution, and widespread access to clean energy.

Disclosure: Some of the study author have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference  

GBD 2019 Respiratory Tract Cancers Collaborators. 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. Lancet Respir Med. 2021;9(9):1030-1049. doi:10.1016/S2213-2600(21)00164-8