Liu Wei, Peng Zhen-Zhen, Guo Yu, Liao Kui
Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Chongqing Medical University, Chongqing, China.
J Thorac Dis. 2025 Jun 30;17(6):3772-3782. doi: 10.21037/jtd-2025-114. Epub 2025 Jun 25.
Tracheal, bronchus, and lung (TBL) cancer is one of the most prevalent and fatal malignancies worldwide, with China accounting for one-third of global new cases and deaths. This study aims to compare the differences in TBL cancer burden between China and the global population.
Based on the Global Burden of Disease (GBD) 2021 data, the study analyzed the trends in incidence, mortality, and disability-adjusted life years (DALYs) of TBL cancer in China and the global population from 1990 to 2021. Decomposition analysis was used to quantify the contributions of population growth, aging, and epidemiological changes to the cancer burden, and the attribution proportions of risk factors were assessed.
The global TBL cancer burden showed a declining trend, while China experienced an increase, particularly in incidence rates. For instance, the incidence rate of TBL cancer in Chinese men rose from 48.46 per 100,000 in 1990 to 62.63 per 100,000 in 2021, whereas the global rate showed a decreasing trend. Aging was identified as the primary driver of the increasing burden in China, with environmental factors and occupational exposures having a more significant impact than in other countries.
The rising TBL cancer burden in China highlights the urgent need for strengthened tobacco control, improved screening, especially among the elderly, and addressing environmental and occupational exposures. The study provides a basis for developing targeted public health strategies.
气管、支气管和肺癌（TBL）是全球最常见且致命的恶性肿瘤之一，中国的新发病例和死亡人数占全球的三分之一。本研究旨在比较中国与全球人群中TBL癌症负担的差异。
基于《2021年全球疾病负担（GBD）》数据，该研究分析了1990年至2021年中国和全球人群中TBL癌症的发病率、死亡率及伤残调整生命年（DALY）趋势。采用分解分析来量化人口增长、老龄化和流行病学变化对癌症负担的贡献，并评估风险因素的归因比例。
全球TBL癌症负担呈下降趋势，而中国则呈上升趋势，尤其是发病率。例如，中国男性TBL癌症发病率从1990年的每10万人48.46例升至2021年的每10万人62.63例，而全球发病率呈下降趋势。老龄化被确定为中国负担增加的主要驱动因素，环境因素和职业暴露的影响比其他国家更为显著。
中国TBL癌症负担的上升凸显了加强控烟、改善筛查（尤其是针对老年人）以及应对环境和职业暴露的迫切需求。该研究为制定有针对性的公共卫生策略提供了依据。
