Global burden of smoking-related cancers from 1990 to 2021: insights from the Global Burden of Disease study

Background The global cancer mortality burden was exceptionally high, especially due to smoking-related cancers. This study aimed to analyze the global burden of smoking-related cancers from 1990 to 2021. Method Epidemiological data from the 2021 Global Burden of Disease (GBD) study was used to analyze the burden of smoking-related cancers across different ages, genders, and regions. The Joinpoint regression model was applied to evaluate trends in cancer burden during 1990-2021, while decomposition analysis visually represented the contributions of aging, population growth, and epidemiological changes to the variation of burden. Additionally, autoregressive integrated moving average (ARIMA) model was used to predict the burden over the next 15 years. Result Smoking was the leading level 4 risk factor contributing to cancer deaths. The global smoking-related cancer death number increased from 1328875 [95% uncertainty interval (UI): 1154027, 1511048)] to 2012845 (95%UI: 1682778, 2369033) during 1990-2021. The top four smoking-related cancer death number were tracheal, bronchus, and lung cancer; esophageal cancer; stomach cancer; and larynx cancer in 2021. The global age-standardized mortality rate (ASMR) of smoking-related cancers decreased from 33.76 (95%UI: 29.23, 38.45) in 1990 to 23.31 (95%UI: 19.49, 27.43) in 2021, which declined most rapidly in high socio-demographic index (SDI) region [average annual percentage change (AAPC): -1.80)] and males (AAPC: -1.28). Stomach cancer had the steepest decline of ASMR, with an AAPC of -2.60 (p<0.001). There was a positive correlation between ASMR and SDI in 2021 (R=0.60). The age group with the highest death number of smoking-related cancer shifted from 65-69 years old to 70-74 years old during 1990-2021. In addition, ASMRs of smoking-related cancers is predicted to continue to decline in both genders and across all SDI regions over the next 15 years. Conclusions Smoking-related cancers are a significant global public health issue. Despite the decline in ASMR of smoking-related cancers, the absolute death number of smoking-related cancers continued to rise. Therefore, making specific tobacco control policies is crucial to address the smoking-related health challenges.