Global burden of Tracheal, bronchus, and lung cancer based on age and sex: a systematic trend analysis of the global burden of disease study 2021

Background Tracheal, bronchus, and lung (TBL) cancer is a serious respiratory disease. Epidemiological patterns of TBL cancer across 204 countries and territories from 1990 to 2021 was analyzed in this study. Methods Data was extracted from the Global Burden of Disease (GBD) 2021 study. Population was divided into young-set (25 ~ 49), middle-set (50 ~ 69) and old-set (≥ 70) based on age. Age-stratified and sex-stratified TBL cancer patterns were analyzed at global, region and nation levels. Average annual percent change (AAPC) was calculated to exhibit the TBL cancer trend based on age standardized incidence rate (ASIR) and age standardized mortality rate (ASMR). ASMR trends caused by causes were also investigated to uncover the risk shifts of TBL cancer deaths. Besides, the Bayesian age-period-cohort model incorporating integrated nested Laplace approximations was applied to forecast future TBL cancer burden. Results Globally, ASIR and ASMR per 100,000 population decreased from 28.54 and 27.58 in 1990 to 26.43 and 25.85 in 2021, respectively. However, female ASIR and ASMR are increasing lightly. The ASIR and ASMR of young-set TBL cancer decreased significantly with AAPC of -1.38[95% confidence interval (CI): -1.54~-1.22; P  < 0.05] and − 1.62[95%CI: -1.76 ~ -1.49; P  < 0.05]. The ASIR and ASMR also decreased with AAPC of -0.82 [95%CI: -0.90 ~ -0.73; P  < 0.05] and − 1.14[95%CI: -1.23~-1.06; P  < 0.05] among middle-set. Conversely, the old-set ASIR and ASMR increased with AAPC of 0.47 [95%CI: 0.41 ~ 0.53; P  < 0.05] and 0.16 [95%CI: 0.02 ~ 0.30; P  < 0.05]. Behavioral/occupational risks were the main reasons for TBL cancer deaths. In the future, old-set population would still possess the highest TBL cancer burden, and female burden would furtherly increase. Conclusion Although the global TBL cancer burden is experiencing decreasing, sex-specific and age-specific disparities still persisted. Tobacco is still main reason for TBL cancer deaths. Female deserves more attention due to predicted heavy female TBL cancer trend.