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Journal of Cancer Research and Clinical Oncology logoLink to Journal of Cancer Research and Clinical Oncology
. 2022 Jul 29;149(7):3209–3218. doi: 10.1007/s00432-022-04217-5

Burden of lung cancer along with attributable risk factors in China from 1990 to 2019, and projections until 2030

Yuan Fang 1, Zhen Li 1, Hui Chen (V体育官网) 2,3, Tongchao Zhang 1,2,3, Xiaolin Yin 1, Jinyu Man 1, VSports - Xiaorong Yang 2,3,✉, Ming Lu 1,2,3,✉
PMCID: PMC11797656  PMID: 35904601

V体育ios版 - Abstract

"VSports" Objective

This study aimed to identify and project the epidemiological trends and the burden of lung cancer in China.

VSports最新版本 - Methods

We extracted incidence, mortality, disability-adjusted life-years (DALYs) and age-standardized rates of lung cancer in China, between 1990 and 2019, from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was applied to quantify the trends of lung cancer burden V体育平台登录. Furthermore, we used the Bayesian age-period-cohort model to project the incidence and mortality in the next decade.

Results

From 1990 to 2019, the estimated national number of lung cancer incident cases increased by 224. 0% to 832,920, deaths increased by 195. 4% to 757,170 and DALYs increased by 146. 1% to 17,128,580, respectively. Meanwhile, the ASIR, ASMR and ASDR showed an upward trend (EAPC of 1. 33, 0. 94 and 0. 42, respectively). The ASIR and ASMR among males were about 2 times more than females, but the increase in ASIR in females (EAPC = 2. 24) was more obvious than those in males (EAPC = 0. 10) from 2020 to 2030. In China, smoking remained responsible for the highest burden of lung cancer, but the contribution of ambient particulate matter pollution to DALYs increased from 10. 6% in 1990 to 22. 5% in 2019 in total population. Moreover, we predicted that the number of deaths from lung cancer will increase by 42 VSports注册入口. 7% in China by 2030.

Conclusion

In China, the burden of lung cancer has been increasing over the past three decades, which highlights more targeted intervention measures are needed to reduce the burden of lung cancer.

Supplementary Information

The online version contains supplementary material available at 10. 1007/s00432-022-04217-5 VSports在线直播.

Keywords: Lung cancer, China, Trends, Risk factors, Projections

Introduction

Lung cancer continues to be the leading malignant tumor that threatens people's lives and health (Hong et al. 2015), being the second in incidence (accounting for 11. 4% of cases) and the first in mortality (accounting for 18% of deaths) in the world (Sung et al. 2021; Cao and Chen 2019). Lung cancer incidence and mortality rates have been decreasing in most Western countries (Sung et al. 2021), while increasing in China. According to the 2020 Global Cancer Statistics Report, among a total of 1 VSports. 8 million lung cancer deaths, 39. 4% of lung cancer deaths appeared in China. In 2020, China is estimated to have 820,000 new lung cancer cases (accounting for 17. 9% of all cancer cases) and 710,000 deaths (accounting for 23. 8% of all cancer deaths) were estimated in China, both of which rank first among all cancer types (Sung et al. 2021; Cao and Chen 2019).

The occurrence and progression of lung cancer originate from the influence of multiple factors (Malhotra et al. 2016), and smoking is recognized as the most important high-risk factor for lung cancer (Huo et al. 2020). Unfortunately, in China, the burden of tobacco-related cancers is increasing despite many targeted measures such as anti-smoking campaigns (Deng et al. 2021). Also, with social development, air pollution, occupational environment and eating habits are significantly related to the risk of lung cancer (Mao et al. 2016), and their burden-inducing effects are changing. In recent years, the burden of lung cancer among women is gradually increasing (Tolwin et al. 2020) VSports app下载. Therefore, understanding the current landscape and potential trajectories of the burden of lung cancer are a significant foundation for long-term cancer control actions.

The Global Burden of Disease (GBD) study systematically evaluates the incidence, mortality, and DALYs rate of lung cancer (Deng et al. 2020), providing us with a unique opportunity to understand the burden of lung cancer in China. This study is based on China’s latest GBD (2019) research data to describe the temporal trend of lung cancer disease burden and risk factors by gender and age group from 1990 to 2019. Our research results not only support us increase our understanding of the burden of disease, but also serve to allocate medical resources for the management of lung cancer V体育官网. Finally, we also predicted the incidence and mortality of lung cancer in the next 10 years, which can provide information for future prevention strategies and clinical practice. .

"VSports在线直播" Materials and methods

"VSports注册入口" Data source

The previous studies have reported the detailed methods of the GBD study (2019) (James et al. 2018; Etemadi et al. 2020; Vos et al. 2020). The GBD study provides countries around the world with annual age-sex-specific incidence, mortality and DALYs rates. We extracted the lung cancer-related incidence, mortality and DALYs from the Institute for Health Metrics and Evaluation (IHME, http://ghdx. healthdata. org/gbd-results-tool). The 95% uncertainty intervals (95% UIs) of each estimate in the GBD study were generated by the 2. 5th and 97. 5th-ordered percentiles of 1000 draws of the uncertainty distribution (Vos et al. 2020). In the online database, we chose “China” as the location, “lung cancer” as the cause, and “incidence”, “death” and “DALYs” as measures for selection. In addition, we described the incidence and deaths of lung cancer in China by age and sex and also estimated the percentage changes of these indicators from 1990 to 2019. Finally, the estimated Chinese population was acquired from the United Nations World Population Prospects 2019 Revision, by year, sex, and age (https://population. un VSports手机版. org/wpp/Download/Standard/Population/).

Assessment of lung cancer burden

The incidence and mortality of lung cancer in GBD were determined by the following methods: first, a linear-step mixed-effect model was used to estimate the mortality-to-incidence ratio (MIR) (Zhang et al. 2021; Liu et al. 2019) and the Spatiotemporal Gaussian process regression was used to adjust the estimation for all data sources reporting the incidence and mortality of lung cancer with international disease classification codes (Vos et al. 2020; Zhang et al. 2021). Second, the lung cancer-related incidence data from various single cancer registries or aggregated databases of cancer registries were obtained. Third, the mortality estimate was calculated by multiplying the cancer registration incidence data by the MIR (Vos et al. 2020). Finally, the cancer-specific mortality of lung cancer was determined by the Cause of Death Ensemble model (Vos et al. 2020; Zhang et al. 2021; Liu et al. 2019) V体育安卓版.

For the risk factors, the proportion of DALYs attributable to risk factors (smoking, ambient particulate matter pollution, second smoking, occupational carcinogens, high fasting plasma glucose, residential radon and diet low in fruits) by age and sex was evaluated through the comparative risk assessment (CRA) framework (Zhang et al. 2021; Yang et al. 2021), which included the following key steps: first, the risk-outcome pairs with persuasive and possible evidence were identified based on research (Murray et al. 2020). Second, the relative risk of exposure was summarized through a systematic review. Third, using the spatiotemporal Gaussian process regression, DisMod-MR 2.1, and other methods estimate the distribution and exposure level (Murray et al. 2020). Finally, calculating the population attributable fractions (PAFs) and attributable burdens of potential risk factors (Zhang et al. 2021; Murray et al. 2020).

Statistical analysis

We conducted a descriptive analysis of lung cancer incidence, mortality, and DALYs according to the 5-year-old age group, gender, and year; and plotted the time trends of these indicators from 1990 to 2019. Age was divided into 18 age-specific groups every 5 years starting from 10 years. To avoid the influence of the age composition of the population, the age-standardized rates were calculated using the direct method (GBD world population age standard) to estimate the lung cancer burden. We used the estimated annual percentage change (EAPC) to measure the time trends of age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). EAPC was calculated based on a regression model fitted to the natural logarithm of the rate, namely ln(rate) = α + β × (calendar year) + ε. EAPC was defined as 100 × (exp(β) − 1); its 95% confidence interval (95% CI) was also calculated in the fitted model. In addition, the Bayesian age-period-cohort (BAPC) model was applied to project the lung cancer burden because of its higher accuracy (Yu et al. 2021; Knoll et al. 2020; Du et al. 2020). Briefly, the age-period-cohort model is often considered as a log-linear Poisson model: ηij = log(λij) = μ + αi + βj + γk. In the model, λij represents the number of cases, μ represents the intercept, and αi, βj, and γk represent age, period, and cohort effects, respectively. i (1 ≤ i) signifies age group at time point j (1 ≤ j ≤ J); k signifies the cohort index, k = M (I − i) + j, which depends on age, period index, and the length of the age group and period interval. M means that the age group intervals are M times wider than the period interval. In our study, M is 5 for 5-year age groups and yearly data. We applied the BAPC model fitted with Integrated Nested Laplace Approximation (R packages BAPC and INLA) to adjust the overdispersion. All analyses were performed using R (version 4.0.3), and a two-sided P value less than 0.05 was considered statistically significant.

Results

VSports app下载 - The current burden of lung cancer in China

In 2019, the estimated newly diagnosed lung cancer patients in China were 832,920 (95% UI: 700.29, 981.63), corresponding to ASIR with around 41.71 (95% UI: 35.22, 48.80) cases per 100,000 population (Table S1). About 757,170 (95% UI: 638.74, 877.75) people died of lung cancer in 2019, accompanied by ASMR with around 38.70 (95% UI: 32.80, 45.03) per 100,000 population (Table S2). Likely, an estimated 17,128,580 (95% UI: 14340.49, 20231.34) DALYs in 2019 were attributed to lung cancer, with the ASDR at 831.27 per 100,000 population (Table S3).

In 2019, the estimated number of incident cases and DALYs of lung cancer reached a peak among the total population aged 65–69 years (Tables S1–S3), while the estimated number of deaths reached a peak at 70–74 years old (Table S2). Meanwhile, the age-specific incidence and mortality of lung cancer rose to a peak at age 85–89 years among the total population, while the peak of age susceptibility of the DALYs rate shifted to 75–79 years (Tables S1–S3). Remarkably, lung cancer incidence and mortality rates are relatively low under the age of 40 and the corresponding results may be unstable.

The estimated number and age-standardized rates of incidence, mortality and DALYs among men were about 2 times more than women across almost all age groups (Tables S1–S3, Fig. 1). Regarding the age-specific rates of incidence and DALYs, males and females had similar characteristics and trends, which increased first and then decreased (Fig. 1A, C). However, the trend of age-specific rates of mortality presented slight differences in genders. In males, the age-specific rates of mortality rose to a peak at age 85–89 years, remained relatively high level until age 90–94 years, and declined afterward. In females, the mortality rate of lung cancer continued to increase with age (Fig. 1B).

Fig. 1.

Fig. 1

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Numbers and rates of incidence (A), mortality (B) and DALYs (C) of lung cancer by age and sex in 2019 in China. Shading represents the upper and lower limits of the 95% uncertainty intervals (95% UIs). DALYs, disability-adjusted life-years

The trends in incidence, mortality and DALYs of lung cancer

From 1990 to 2019, the estimated number of lung cancer incident cases, deaths, and DALYs increased dramatically in the overall population, but the degree of rising decreased after age standardization. (Tables S1–S3). Both the ASIR and the ASMR showed generally an upward trend from 1990 to 2019, increasing from 30.2 per 100,000 (95% UI: 26.20, 34.26) to 41.71 per 100,000 (95% UI: 35.22, 48.80) and from 31.18 per 1,000,000 (95% UI: 27.14, 35.52) to 38.70 per 100,000 (95% UI: 332.80, 45.03), respectively. From 1990 to 2019, the estimated number of incident cases increased most significantly at age 65–74 years, regardless of gender (Fig. 2A). The incidence rate gradually increased among the population aged over 55 years, especially among men and the population aged 85–89 years (Fig. 2B, C). However, it was among the population aged over 60 years that the mortality increased (consistent with DALY rate) (Figure S1).

Fig. 2.

Fig. 2

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Number of incident cases (A), incidence rate (B) of lung cancer by age and sex, from 1990 to 2019 in China; EAPC of incidence rate (C) of lung cancer by age and sex in 2019 in China. EAPC estimated annual percentage change

The ASIR of lung cancer increased overall in both sexes from 1990 to 2019 (male: EAPC = 1.49; female: EAPC = 1.08), as did ASMR and ASDR (Figure S2). For males, the ASIR and ASMR showed a slight downward trend since 2010 and had a temporary decline in 2005. While for females, the changes in the ASIR and ASMR were not significant (Figure S2A-B). Additionally, compared to females, the trend in the incidence rate and mortality among males changed more dramatically in most age-specific groups from 1990 to 2019 (Fig. 2, Figure S1).

"V体育ios版" The risk factors for lung cancer

We calculated the proportion of DALYs by sex and age attributable to risk factors (including smoking, ambient particulate matter pollution, etc.) from 1990 to 2019 (Fig. 3A, B). It was observed that DALY rates associated with smoking first increased and then decreased in most age-specific groups and both genders (Figure S3). The effect of high fasting plasma glucose on DALYs increased with age, while household air pollution from solid fuels tended to decrease. In addition, we found that there were no significant age differences in the proportion of DALYs due to ambient particulate matter pollution and residential radon, with similar proportions in all age-specific groups (Fig. 3B).

Fig. 3.

Fig. 3

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Proportions of DALYs attributable to risk factors by sex from 1990 to 2019 in China (A); and proportions of DALYs attributable to risk factors by age and sex in 2019 in China (B). DALYs, disability-adjusted life-years

The proportion of DALYs caused by smoking was the highest for both genders in 2019 (79.9% in males and 21.9% in females). In addition, the proportion of males was twice that of females, while the proportion caused by secondhand smoke was the opposite. Other than that, there were no significant gender differences in other risk factors. Of concern, the proportion of DALYs caused by ambient particulate matter pollution increased from 10.6% in 1990 to 22.5% in 2019 in total population, while household air pollution from solid fuels decreased from 22.1% in 1990 to 5.0% in 2019 (Fig. 3A).

Prediction of lung cancer incidence and death rate in China in the next ten years

Based on the lung cancer GBD data in China from 1990 to 2019, we further predicted the ASIR, ASMR and the estimated number of incident cases and deaths from 2020 to 2030. In the next 10 years in China, it is predicted that only male ASMR will decrease [EAPC = − 0.537, 95% CI: (− 0.594, − 0.481)], while female ASIR, ASMR and male ASIR will increase [EAPC = 2.236, 95% CI: (2.175, 2.296) vs. EAPC = 1.542, 95% CI: (1.480, 1.605) vs. EAPC = 0.101, 95% CI: (0.044, 0.158), respectively] (Fig. 4A–D). By 2030, the estimated number of deaths from lung cancer will increase by 42.7% in China. Interestingly, while the estimated number of new cases and deaths in China is expected to continue to increase among men and women for the next decade, it will increase faster in females than in males (Fig. 4E, F). The shading in Fig. 4E and F represent the change in the estimated number of incident cases and deaths when the corresponding probability increases or decreases by one percent.

Fig. 4.

Fig. 4

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Temporal trends and forecasted rates of incidence (A, C) and death (B, D), and number of incident cases (E) and deaths (F) of lung cancer by sex, from 2020 to 2030 in China. Shading represents a 1% decrease and increase interval based on the 2019 rate

Discussion

In this study, we reported systematically the current situation of lung cancer, risk factors and the time trends in incidence, mortality, and DALYs rate by sex and age groups in China along with predicting the changes in the next 10 years. Our study suggested that age-standardized rates of lung cancer were higher in men than in women in China. However, the increasing trends of ASIR and ASMR in females were relatively pronounced especially in the next 10 years. Moreover, regardless of gender, the ASIR and ASMR of lung cancer overall were increasing in the past three decades, suggesting that the burden of lung cancer disease in China is not optimistic. For the risk factors, the contribution of smoking to lung cancer remains high, especially among men, and the impact of ambient particulate matter pollution is increasing.

Some studies found sex differences in the distribution of lung cancer (Deng et al. 2020), and our results showed that the ASIR and ASMR were twice higher in males than females in the past thirty years. In China, 57.4% of males smoke compared to 2.6% of females (Yang et al. 2005), which may help explain the above phenomenon. Moreover, our prediction results showed that the growth of ASIR in males will slow down, which may benefit from measures to curb smoking. Risk factors of lung cancer in non-smoking women deserve more attention in China, where smoking rates among women are low (Yang et al. 2005; Sun et al. 2007). Studies indicated that exposure to secondhand smoking increases the risk of lung cancer, with significantly higher rates of exposure to secondhand smoking among women than men (64% vs. 38%) (Kawaguchi et al. 2011). Meanwhile, our results found a higher proportion of DALYs attributable to secondhand smoke among women. Furthermore, household air pollution, a significant source of which is cooking, has been confirmed to cause respiratory diseases (Liu et al. 2018). In China, considering that women mostly play a dominant role in domestic cooking (Pauk et al. 2005), household air pollution is one of the important risk factors for lung cancer in women, especially non-smoking women. Third, sex differences in lung cancer suggest the involvement of genetic and hormonal factors (Musial et al. 2021; Mederos et al. 2020), women are more susceptible to develop adenocarcinoma rather than squamous cell carcinoma and adenocarcinoma accounts for three-fourths of primary lung cancers in women (Stapelfeld et al. 2020; Maitra et al. 2021). On the one hand, it is because about 76% of lung adenocarcinomas have K-RAS mutation, which is more commonly found in females than males (Mederos et al. 2020; Stapelfeld et al. 2020). On the other hand, a clinical study in women showed an increased risk of adenocarcinoma in patients receiving hormone replacement therapy. Interestingly, one study found genetic variants on the X chromosome were associated with lung cancer risk regardless of smoking (Liang et al. 2018; Shi et al. 2021). Consequently, some male individuals with X-linked susceptibility genes are more likely to develop lung cancer (Shi et al. 2021), which further explains the high incidence of lung cancer in men.

Lung cancer is closely related to smoking, with about 85% of lung cancers attributable to smoking, and China is the largest producer and consumer of tobacco (Moldovanu et al. 2021). Effective tobacco control policies have been proven to reduce lung cancer incidence in the US since 1999 (Zheng et al. 2016). To curb the tobacco epidemic, China has signed the WHO Framework Convention on Tobacco Control (FCTC) and formulated relevant anti-smoking policies such as banning smoking in public places and tobacco advertising (She et al. 2013). Despite the implementation of various tobacco control measures in China, the smoking rate remains high, at 26.6% in 2018 (Li and Galea 2019), which is higher than the “Healthy China 2030” target smoking rate (20%). Furthermore, the smoking rates among young women are also steadily rising (Jin et al. 2021), in parallel with our predicted ASIR of female lung cancer. More worryingly, smoking rates among young people are increasing in recent years, rising from 17.9% in 2010 to 18.6% in 2018 among aged 15–24 (Wang et al. 2019). In addition, the popularity of e-cigarettes presented new challenges for youth smoking control (Singh and Chaturvedi 2020). A survey found that 90% of respondents were aware of e-cigarettes and nearly a quarter had used them (He et al. 2020). Tobacco control remains important to addressing lung cancer in the future. Therefore, China urgently needs more practical anti-smoking policies targeting youth and women.

Besides smoking, ambient particulate matter pollution, another risk factor that cannot be ignored, has been listed as the main human carcinogen (Abayalath et al. 2021). However, China is one of the countries with the worst air quality in the world, and the air quality of 53.7% of China's cities has reached dangerous levels (Yin et al. 2020). In recent years, the government has taken a series of measures to improve air quality, such as restricting factory emissions, developing green new energy sources, and controlling traffic flow (Huang et al. 2017). But our research showed that from 1990 to 2019, the proportion of DALYs of lung cancer attributable to ambient particulate matter pollution increased year by year. We also considered other common risk factors, with household air pollution from solid fuels as a lung cancer risk factor. Additionally, about 79% of people in rural areas of China use solid fuels much higher than in developed countries (5%) (Household use of solid fuels and high-temperature frying 2010; Liu et al. 2020). Fortunately, as China’s economy develops, the proportion of DALYs in lung cancer attributable to household air pollution from solid fuels is declining year by year. Notably, household air pollution from solid fuels in less developed areas is still inevitable (Yu et al. 2020). Second, among non-smokers, residential radon is the primary cause of lung cancer, but there are few national surveys of residential radon in my country (Rodríguez-Martínez et al. 2018). Therefore, future research in this area should be strengthened and residential radon should be fully considered in the formulation of lung cancer prevention strategies in the future. Meanwhile, people in the chemical, mining and manufacturing industries are at risk of occupational lung cance (Loomis et al. 2018). Several studies in China revealed that red meat and alcoholic beverages increase the risk of lung cancer to some degree (Islami et al. 2017), and that lung cancer deaths are significantly associated with low vegetable intake (He et al. 2020).

The incidence of lung cancer in China still on the rise, with a five-year survival rate of 19.7% despite improving medical technology (Zeng et al. 2018), suggesting that efforts are still needed to control the burden of lung cancer. The burden of lung cancer in China remains high, partly due to the large population base (Feng et al. 2018). At the same time, China is transitioning to an aging country, which may lead to a concentration of morbidity and mortality in the elder population, thus increasing the disease burden of lung cancer.

On the other hand, differences in risk factor exposure levels may play a role, especially tobacco exposure. Adult smoking rates in the United States have fallen to 14% in 2017 (Wang et al. 2018), while China has never been below 20% (Li and Galea 2019).

For lung cancer prevention, the immediate priority in China is still to control smoking rates and exposure to secondhand smoke (Xia et al. 2019). Also, a comprehensive smoke-free policy should be expanded to all provinces rather than limited to metropolitan areas. Then, it is necessary to raise tobacco taxes and costs, add picture warnings on cigarette packages instead of Chinese text, expand the coverage area of warnings on packages and actively publicize the hazards of residential radon, etc. At present, low-dose computed tomography (LDCT) screening for high-risk groups may be more appropriate for the national situation in China. Therefore, the future direction of lung cancer prevention and treatment in China is first to promote lung cancer screening programs on a large scale for early diagnosis and treatment, and second to establish a high-risk assessment system suitable for the Chinese population. Chinese government-sponsored lung cancer screening programs have been implemented in rural and urban areas (He et al. 2020), which will contribute to the prevention and treatment of lung cancer in China.

This study still has some limitations. First of all, because the data come from different sites, there may be incompatibility, which may have a certain impact on our results. Although we have used various mathematical models to correct the data in our research, we cannot ignore this fact. Second, the lung cancer burden attributable to other risk factors, such as genetic factors, did not be investigated due to the limited information in the GBD database. Finally, we could not analyze different histological types of lung cancer. Lung cancer can be divided into small cell lung cancer and non-small cell lung cancer according to histological classification (Sanaei et al. 2021), and they differ in incidence trend, death risk and risk factors.

In summary, the incidence, mortality and DALYs of lung cancer in China presented an increasing trend in the past 30 years, and it is expected that the number of new lung cancer cases and deaths will continue to increase in the next decade. In addition, smoking remained responsible for the highest-burden of lung cancer, but the contribution of ambient particulate matter pollution to lung cancer showed an increasing trend. Therefore, based on the growing lung cancer burden in China, more detailed and targeted prevention and control strategies should be implemented, such as lung cancer screening and anti-smoking measures with Chinese characteristics.

Supplementary Information

Below is the link to the electronic supplementary material.

432_2022_4217_MOESM1_ESM.jpg (2MB, jpg)

Supplementary file1 Figure S1. Mortality rate (A) and DALYs rate (C) of lung cancer by age and sex, from 1990 to 2019 in China; EAPC of mortality rate (B) and EAPC of DALYs rate (D) of lung cancer by age and sex in 2019 in China. DALYs, disability-adjusted life-years; EAPC, estimated annual percentage change. (JPG 2018 KB)

432_2022_4217_MOESM2_ESM.jpg (2.8MB, jpg)

Supplementary file2 Figure S2. Numbers and age-standardized incidence (A), mortality (B) and DALYs (C) of lung cancer per 100,000 population by sex in China from 1990 to 2019. Shading represents the upper and lower limits of the 95% uncertainty intervals (95% UIs). DALYs, disability-adjusted life-years. (JPG 2918 KB)

432_2022_4217_MOESM3_ESM.jpg (2.1MB, jpg)

Supplementary file3 Figure S3. Rates of DALYs of lung cancer attributable to risk factors by age and sex, from 1990 to 2019 in China. (A) Both; (B) Men; (C) Women. (JPG 2182 KB)

432_2022_4217_MOESM4_ESM.docx (36.9KB, docx)

Supplementary file4 Table S1. The number of incident cases and the incidence rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. Table S2. The number of deaths and the mortality rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. Table S3. The number of DALYs and the DALYs rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. (DOCX 37 KB)

Acknowledgements

We would like to thank the countless individuals who have contributed to the Global Burden of Disease Study 2019 in various capacities. We would like to thank all authors who have contributed to the manuscript.

Abbreviations

DALYs

Disability-adjusted life-years

EAPC

Estimated annual percentage change

ASIR

Age-standardized incidence rate

ASMR

Age-standardized mortality rate

ASDR

Age-standardized DALY rate

UI

Uncertainty interval

CI

Confidence interval

GBD

Global burden of disease;

BAPC

Bayesian age-period-cohort

Author contributions

Guarantor of integrity of the entire study: XRY, ML; study concepts and design: XRY, ML; literature research: all authors; data analysis: YF, ZL, HC, TCZ, XLY, JYM; statistical analysis: XRY, YF; manuscript preparation: XRY, YF; manuscript editing: XRY, ML.

"VSports在线直播" Funding

This work was supported by the National Key Research and Development Program of China (2021YFF1201101), the National Natural Science Foundation of China (82103912, 82173591 and 81973116), the China Postdoctoral Science Foundation (2021M700080), and the Shandong Provincial Natural Science Foundation (ZR2020QH302). The funders were not involved in the collection, analysis or interpretation of the data, or the writing or submitting of this report.

"VSports在线直播" Data availability

All data could be extracted from online data (http://ghdx.healthdata.org/gbd-results-tool).

Declarations

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The GBD 2019 study is a publicly available database and all data were anonymous. Our study protocol was approved by the Institutional Review Boards of Qilu Hospital of Shandong University with approval number KYLL-202011(KS)-239.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Xiaorong Yang, Email: yangxiaorong@www.qiuluzeuv.cn.

Ming Lu, Email: lvming@www.qiuluzeuv.cn.

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"VSports注册入口" Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

432_2022_4217_MOESM1_ESM.jpg (2MB, jpg)

Supplementary file1 Figure S1. Mortality rate (A) and DALYs rate (C) of lung cancer by age and sex, from 1990 to 2019 in China; EAPC of mortality rate (B) and EAPC of DALYs rate (D) of lung cancer by age and sex in 2019 in China. DALYs, disability-adjusted life-years; EAPC, estimated annual percentage change. (JPG 2018 KB)

432_2022_4217_MOESM2_ESM.jpg (2.8MB, jpg)

Supplementary file2 Figure S2. Numbers and age-standardized incidence (A), mortality (B) and DALYs (C) of lung cancer per 100,000 population by sex in China from 1990 to 2019. Shading represents the upper and lower limits of the 95% uncertainty intervals (95% UIs). DALYs, disability-adjusted life-years. (JPG 2918 KB)

432_2022_4217_MOESM3_ESM.jpg (2.1MB, jpg)

Supplementary file3 Figure S3. Rates of DALYs of lung cancer attributable to risk factors by age and sex, from 1990 to 2019 in China. (A) Both; (B) Men; (C) Women. (JPG 2182 KB)

432_2022_4217_MOESM4_ESM.docx (36.9KB, docx)

Supplementary file4 Table S1. The number of incident cases and the incidence rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. Table S2. The number of deaths and the mortality rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. Table S3. The number of DALYs and the DALYs rates of lung cancer in China in 1990 and 2019 and the estimated annual percentage changes from 1990 to 2019. (DOCX 37 KB)

"V体育平台登录" Data Availability Statement

All data could be extracted from online data (http://ghdx.healthdata.org/gbd-results-tool).

Articles from Journal of Cancer Research and Clinical Oncology are provided here courtesy of Springer

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