Tracheal, Bronchial, and Lung Cancer Disease Burden and Risk Factors in China, Japan, and Southeast Asia from 1990 to 2021: Results from the Global Burden of Disease 2021 Study

Background: Tracheal, bronchial, and lung cancer (TBL cancer) is the leading cause of cancer mortality in numerous Asian countries, we analyzed time-based trends in the disease burden of TBL cancer, as well as its associated risk factors, in China, Japan, and Southeast Asia.Methods: We first obtained TBL cancer data from the 2021 Global Burden of Disease Study.We then investigated longitudinal trends in TBL cancer disease burden in China, Japan, and Southeast Asia from 1990 to 2021 by calculating estimated annual percentage change (EAPC) values through linear regression modeling.We next used an autoregressive integrated moving average (ARIMA) model to predict future disease burden (for 2022-2050).Finally, we analyzed risk factors for TBL cancer.Results: In 2021, there were 814364 TBL cancer-related deaths in China (95% UI:652636-987795), 92119 (95% UI:78912-98959) in Japan, and 134949 (95% UI: 110670-155974) in Southeast Asia.Between 1990 and 2021, ASDR (EAPC: 0.42 (95% UI: 0.25-0.6))and age-standardized disability-adjusted life years (DALYs; EAPC: 0.07 (95% UI: -0.08-0.21))forTBL cancer in China increased, but decreased in both Japan and Southeast Asia.In these regions, TBL disease burden remains much greater in men than in women.The main risk factor for TBL cancer in all three regions was smoking, but, over time, the proportion of risk attributable to smoking gradually decreased, and the proportion of other risk factors related to air pollution gradually increased.Conclusions: Over the past 30 years, the disease burden of TBL cancer has been generally decreasing in Japan and Southeast Asia, but generally increasing in China.The composition of the major risk factors contributing to TBL cancer has also changed significantly over this time period, meaning that more effective efforts are needed to reduce the burden of TBL, improve treatments, and to help achieve each region's public health and development goals.