Cross-state variations and temporal trends in tracheal, bronchus and lung cancer burden in India from 1990-2021: Mortality projections to 2050.

e22520 Background: Tracheal, Bronchus and Lung Cancer (TBLc) is the 2nd leading cause of death and 3rd leading cause of disability in India, with rising incidence driven by tobacco use, environmental pollution, and regional disparities. Methods: We estimated incidence, prevalence, disability adjusted life years (DALYs), years lived with disability (YLDs) due to TBLc analyzed by age, sex, year and location across India and its territories from 1990-2021 using standardized global burden of disease study 2021 methodology. We projected death due to LC up to 2050 using regression framework. Results: The annual percentage change(APC) in age-standardized incidence rate(ASIR) increased by 0.72%, prevalence rate(ASPR) by 0.78%, mortality rate(ASMR) by 0.68%, disability-adjusted life years(DALYs) rate (ASDALR) by 0.57%, and years lived with disability(YLDs) rate (ASYLDR) by 0.71% from 1990 to 2021. At the sub-national level, the highest increase in APC for ASYLDR was observed in Uttarakhand (1.46%), Gujarat (1.41%), and Uttar Pradesh (U.P.) (1.31%). The highest APC for ASIR was recorded in Uttarakhand (1.56%), U.P. (1.4%), and Gujarat (1.35%) during the same period. For ASMR, the highest increases in APC were noted in Uttarakhand (1.5%),U.P. (1.38%), and Gujarat (1.3%). The APC in ASMR due to TBLc attributable to metabolic risk factors increased by 1.3%, followed by environmental and occupational risk factors (0.2%) and behavioral risk factors (0.05%) from 1990 to 2021. Age-wise, the highest APC in death count was observed in individuals aged 95+ years (8.12%), followed by 90–94 years (7.14%), 85–89 years (6.60%), 80–84 years (6.10%), 75–79 years (4.94%), and 70–74 years (4.24%), with APC decreasing progressively in younger age groups during the study period. Gender-wise, the APC in ASMR was higher in females compared to males (1.82% vs. 0.34%), as was the APC in ASIR (1.9% vs. 0.45%) and ASDALR (1.74% vs. 0.3%) from 1990 to 2021. The total number of deaths due to TBLc is projected to rise by 155,577 (95% uncertainty interval: 99,007–223,304), with the ASMR expected to increase by 5.79 (95% uncertainty interval: 3.99–7.81) per person by 2050. Conclusions: Deaths due to TBLc accounted for 8.73% of all cancer causalities in India in 2021.From 1990 to 2021, there was a notable increase in health metrics like incidence, mortality, and disability rates, particularly in Indian states like Uttarakhand, Gujarat, and Uttar Pradesh. Significant disparities were observed in the impact of aging on health, with the oldest populations facing the highest increases in mortality rates due to TBLc. Females showed higher annual percentage changes in these metrics compared to males. Projections for 2050 indicate a substantial rise in TBLc deaths, emphasizing the need for targeted public health interventions to address these regional and demographic disparities effectively.