[The burden of lung cancer in China from 1990 to 2021]

Objective: This study aims to focus on analyzing the disease burden trends of lung cancer in China from 1990 to 2021, combined with the Socio-Demographic Index (SDI), to identify influencing factors and predict future trends, providing support for lung cancer prevention and control policies in China. Methods: The incidence, prevalence, mortality and disability-adjusted life year(DALY) of lung cancer in China from 1990 to 2021 were analyzed in conjunction with the socio-demographic index(SDI). Bayes Age-Period-Cohort model(BAPC), Auto-regressive Integrated Moving Average model(ARIMA)and frontier analysis predict future disease trends. Results: In 2021, the number of incidence of lung cancer in China will reach 934 700 (95%CI: 750 000-1 137 000), of which 622 800 (95%CI: 460 100-803 200) men and 31 900 (95%CI: 245 700-387 200) women. The number of prevalence reached 1 262 300 (95%CI: 1 055 600-1 545 300), including 836 600 men (95%CI: 616 900-1 058 700) and 425 700 women (95%CI: 333 600-533 500). The number of deaths was as high as 814 400 (95%CI: 652 600-987 800), including 546 000 (95%CI: 403 600-702 900) men and 268 400 (95%CI: 21 900-331 300) women. The number of DALY was 18 920 200 (95%CI: 15 100 700-23 11 500), of which 1 283 1900 were males (95%CI: 9 352 200-16 730 800) and 6 088 300 were females (95%CI: 4 755 100-7 606 800). In recent years, all the indicators of lung cancer disease burden have increased with the increase of years. The lung cancer disease burden is heavier with age and is significantly more common in men than women. Joinpoint analysis showed that ASMR(APC=2.21, P<0.05) and ASDR(APC=1.58, P<0.05) reached their peak in 2004. Combined with the spatial distribution of lung cancer disease burden, we found that ASIR, ASPR, ASPR and ASDR all increased with the increase of SDI. Decomposition analysis further verified that the number of deaths caused by lung cancer and the number of DALYs were more correlated with aging, while the incidence and number of cases were more correlated with epidemiological changes. Combining BAPC and ARIMA models to analyze the development of disease burden over the next 15 years, we found that the probability of ASIR and ASPR is on the rise in women, ASPR is on the rise in men, and ASDR is on the decline. Conclusion: The disease burden of lung cancer was significantly correlated with time, space, age and sex.