Decomposition analysis of lung cancer and COPD mortality attributable to ambient PM_2.5 in China (1990-2021)

This study aimed to evaluate the long-term trends in lung cancer (LC) and chronic obstructive pulmonary disease (COPD) mortality attributable to particulate matter (PM_2.5) in China and to identify the contributions of population aging and other risk factors to changes in mortality rates.

Using data from 1991 to 2021, we assessed trends in LC and COPD deaths attributable to PM_2.5 through linear regression. Decomposition analysis was conducted to determine the extent to which changes in mortality rates were driven by demographic and non-demographic factors.

The crude mortality rates attributable to PM_2.5 increased significantly for LC (500.40%) and COPD (85.26%). From 1990 to 2021, LC mortality attributable to PM_2.5 increased annually by 4.11% (95% CI: 3.64%, 4.59%), while COPD mortality decreased annually by 1.23% (95% CI: -0.82%, -1.65%). Decomposition analysis revealed that 43.0% of the increase in LC mortality was due to population aging, and 57.0% was attributed to changes in other risk factors. For COPD, population aging contributed to an 18.547/100,000 increase, whereas other risk factors reduced mortality by 10.628/100,000.

The findings highlight the critical roles of population aging and risk factor modification in LC and COPD mortality trends. Interventions to address aging-related vulnerabilities and air pollution control are essential to mitigate future health burdens.