Magnitude, temporal trends and inequality in global burden of tracheal, bronchus and lung cancer: findings from the Global Burden of Disease Study 2017

INTRODUCTION: We aimed to assess the magnitude, temporal trends and socioeconomic disparity in the global burden of tracheal, bronchus and lung (TBL) from 1990 to 2017, using data extracted from the Global Burden of Diseases study (GBD 2017). METHODS: We extracted data from the GBD 2017 study. A series of comparative and descriptive analyses of the disease burden between females and males and countries with different socioeconomic development statuses (Social Demographic Index, SDI). We also analysed the temporal trends of age-standardised disability-adjusted life year rates (ASDR) of TBL cancer at the global and super-regional level by means of joinpoint regression. Finally, we also calculated Concentration Index to explore trends of between-country inequality in cancer burden from 1990 to 2017. RESULTS: During the past 27 years, the global incidence of TBL cancer cases and death cases has increased by 100% and 82.3% respectively, but the increase number was mainly influenced by population growth and ageing. After adjustment, from 1990 to 2017, the ASDR of TBL has increased by 3% and the age-standardised death rate has decreased by 7%. The global TBL cancer burden fell by 15.3%. The joinpoint analysis revealed that the overall trend of age-standardised TBL cancer burden for both females and males significantly changed twice between 1990 and 2017, and it varied across countries with different SDI values and was also different between females and males. Age-standardised TBL cancer burden was more concentrated in higher socioeconomic development countries, but the development of healthy inequality showed a downward trend in males while showing an upward trend in females. CONCLUSION: The magnitude and temporal trends of TBL cancer burden varied across countries and sex. This study highlighted the importance of crafting health policy to adapt to local conditions to manage the global burden of TBL cancers.