Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis

Junjie Huang; Yunyang Deng; Man Sing Tin; Veeleah Lok; Chun Ho Ngai; Lin Zhang; Don Eliseo Lucero-Prisno 3rd; Wanghong Xu; Zhi-Jie Zheng; Edmar Elcarte; Mellissa Withers; Martin C S Wong

doi:10.1016/j.chest.2021.12.655

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis

Chest. 2022 Apr;161(4):1101-1111. doi: 10.1016/j.chest.2021.12.655. Epub 2022 Jan 11.

Authors

Affiliations

¹ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
² Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
³ School of Population and Global Health, The University of Melbourne, Victoria, Australia; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴ Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁵ School of Public Health, Fudan University, Shanghai, China.
⁶ Department of Global Health, School of Public Health, Peking University, Beijing, China.
⁷ University of the Philippines, Manila, the Philippines.
⁸ Department of Population and Public Health Sciences, Institute for Global Health, University of Southern California, Los Angeles, CA.
⁹ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Global Health, School of Public Health, Peking University, Beijing, China. Electronic address: wong_martin@cuhk.edu.hk.

PMID: 35026300
DOI: 10.1016/j.chest.2021.12.655

Abstract

Background: Lung cancer ranks second for cancer incidence and first for cancer mortality. Investigation into its risk factors and epidemiologic trends could help describe geographical distribution and identify high-risk population groups.

Research question: What is the global incidence, mortality, associated risk factors, and temporal trends of lung cancer by sex, age, and country?

Study design and methods: Data on incidence and mortality were retrieved from the Global Cancer Observatory (GLOBOCAN), Cancer Incidence in Five Continents series I-X, World Health Organization (WHO) mortality database, the Nordic Cancer Registries (NORDCAN), and the Surveillance, Epidemiology, and End Results Program (SEER). We searched the WHO Global Health Observatory data repository for age-adjusted prevalence of current smoking. The Average Annual Percentage Change (AAPC) of the trends were obtained by Joinpoint Regression.

Results: The age-standardized rate of incidence and mortality were 22.4 and 18.0 per 100,000 globally. The lung cancer incidence and mortality were associated with Human Development Index (HDI), Gross Domestic Products (GDP), and prevalence of smoking. For incidence, more countries had increasing trends in females but decreasing trends in males (AAPC, 1.06 to 6.43 for female; -3.53 to -0.64 for male). A similar pattern was found in those 50 years or older, whereas those aged younger than 50 years had declining incidence trends in both sexes in most countries. For mortality, similar to incidence, 17 of 48 countries showed decreasing trends in males and increasing trends in females (AAPC, -3.28 to -1.32 for male, 0.63 to 3.96 for female).

Interpretation: Most countries had increasing trends in females but decreasing trends in males and in lung cancer incidence and mortality. Tobacco related measures and early cancer detection should be implemented to control the increasing trends of lung cancer in females, and in regions identified as having these trends. Future studies may explore the reasons behind these epidemiological transitions.

Keywords: incidence; lung cancer; mortality; temporal trend.

MeSH terms

Aged
Female
Global Health*
Humans
Incidence
Lung Neoplasms* / epidemiology
Male
Mortality
Risk Factors
World Health Organization