Analysis of tracheal, bronchial, and lung cancer attributable to respiratory system-related risk factors in 204 countries and territories from 1990 to 2019.

Introduction: We analyzed trends in the tracheal, bronchial, and lung (TBL) cancer disease burdens attributable to respiratory system-related risk factors in 204 countries and territories from 1990 to 2019. Material and methods: Based on the results of the 2019 Global Burden of Disease study, we calculated and analyzed the estimated annual percentage changes (EAPCs) in the age-standardized disability-adjusted life year (DALY) rates and death rates of TBL cancer attributable to total and four individual risk factors globally, regionally, and nationally. Results: From 1990 to 2019, the age-standardized DALY rate and death rate of TBL cancer only attributable to ambient particulate matter pollution increased globally, and in all Socio-Demographic Index (SDI) quintiles, except for high SDI quintiles. Among regions, the most significant increases in those attributable to smoking were seen in East Asia, while those attributable to ambient particulate matter pollution and secondhand smoke were observed in Western Sub-Saharan Africa. Among countries, the most significant increases in those attributable to smoking were observed in São Tomé and Príncipe (EAPC = 1.76) and Bulgaria (EAPC = 1.90), those attributable to ambient particulate matter pollution were observed in Equatorial Guinea, those attributable to secondhand smoke were found in Lesotho (EAPC = 2.01) and Lebanon (EAPC = 2.13), and those attributable to household air pollution from solid fuels were seen in Mozambique. Conclusions: The burden attributable to ambient particulate matter pollution is increasing, especially in regions such as Western Sub-Saharan Africa and East Asia, and countries such as Equatorial Guinea and Bhutan.