HU Shoucai 1,2,3 , YANG Chenglong 1,2,3 , ZHANG Lingling 4 , LI Fu 1,2,3 , ZHANG Yanan 1,2,3 , LIU Bin 1,2 , LI Qingxin 1,2
  • 1. The First Clinical College of Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, P. R. China;
  • 2. General Thoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, 730050, P. R. China;
  • 3. Highland medicine department, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, 730050, P. R. China;
  • 4. Department of Hepatobiliary Pancreatic Surgery, Qinghai Red Cross Hospital, Xining, 810099, P. R. China;
LI Qingxin, Email: liqxchest@163.com
Air pollution; trachea, bronchus and lung cancer; burden of disease; trends; Joinpoint modeling; prediction; China; the United States
10.7507/1007-4848.202504003
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Objective To systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021. Furthermore, based on predictive models, assess the patterns of disease burden changes from 2022 to 2031, providing a scientific basis for formulating targeted TBL prevention and control strategies. Methods Based on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. Results In 2021, the highest number of deaths and disability-adjusted life years attributed to air pollution were in China (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age standardized mortality rate (ASMR) and age standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend (with an average annual percentage change of<0). From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution in the world and in China and the United States was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution will showed an upward trend globally, while they showed a downward trend in China and the United States. Conclusion Over the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's level is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the elderly population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.

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