Global trends in lung cancer incidence and mortality by age, gender and morphology and forecast: A bootstrap-based...

Lung cancer (LC) is the most commonly diagnosed cancer and the leading cause of cancer-related deaths. Understanding temporal-trends and predicting future burden are essential for effective planning. This study aims to analyse time-trends in LC incidence and mortality and to forecast rates worldwide.

We included LC incidence and mortality rates (1970-2020) across 36 populations in 35 countries spanning America, Europe, Oceania and Asia. Datasets were extracted from Cancer Over Time and CI5plus, stratified by gender, age (<60 and ≥ 60 years), and morphology. Time-trends were assessed using joinpoint regression to calculate average annual percent change (AAPC). Future rates through 2030 were estimated using time-series bootstrap methods, and prediction accuracy was evaluated using normalized root mean squared error from ARIMA model.

LC incidence and mortality rates declined among men in most countries, except for increasing incidence in Norway, Japan, and Israel, and rising mortality in Norway, Spain, Japan, and Republic of Korea. Among women, both rates increased across regions, with the highest AAPC in incidence in France (5.8 %) and in mortality in Norway (3.6 %). Adenocarcinoma incidence increased in both genders, notably in Chile (men: 7.4 %; women: 9.5 %). Squamous-cell and small-cell carcinomas also increased among women in several European countries. By 2030, the highest projected LC rates were in Croatia (men: incidence 54.5, mortality 40.3), Netherlands (women: incidence 43.0) and Northern Ireland (women: mortality 25.0).

Continued tobacco cessation initiatives are essential to reduce LC burden. Additionally, further investigation is warranted to identify the potential association between air-pollution and adenocarcinoma.