Global inequalities in tracheal, bronchus, and lung cancer care quality from 1990 to 2021

Tracheal, bronchus, and lung cancer remains a major global cancer burden, but cross-national comparisons using composite proxy indicators are limited. Using Global Burden of Disease 1990-2021 estimates, we constructed a quality-of-care index (QCI) from incidence, mortality, prevalence, and disability outcomes; assessed temporal and geographic patterns; modeled associations with linear mixed models; and compared older adults with the overall population. Age-standardized incidence and death rates declined globally, but QCI remained highly unequal across 204 countries. QCI was higher in high-development settings, lower in low-development settings, and generally lower among older adults than in the overall population. Socioeconomic development was positively associated with QCI, whereas older age was negatively associated with QCI. These findings identify persistent inequities in this outcome-based proxy indicator and support SDI-stratified and aging-responsive lung cancer care strategies.