Comparative analysis of tracheal, bronchus, and lung cancer burden trends between China and the global population (1990-2021).

Background: Tracheal, bronchus, and lung (TBL) cancer is one of the most prevalent and fatal malignancies worldwide, with China accounting for one-third of global new cases and deaths. This study aims to compare the differences in TBL cancer burden between China and the global population. Methods: Based on the Global Burden of Disease (GBD) 2021 data, the study analyzed the trends in incidence, mortality, and disability-adjusted life years (DALYs) of TBL cancer in China and the global population from 1990 to 2021. Decomposition analysis was used to quantify the contributions of population growth, aging, and epidemiological changes to the cancer burden, and the attribution proportions of risk factors were assessed. Results: The global TBL cancer burden showed a declining trend, while China experienced an increase, particularly in incidence rates. For instance, the incidence rate of TBL cancer in Chinese men rose from 48.46 per 100,000 in 1990 to 62.63 per 100,000 in 2021, whereas the global rate showed a decreasing trend. Aging was identified as the primary driver of the increasing burden in China, with environmental factors and occupational exposures having a more significant impact than in other countries. Conclusions: The rising TBL cancer burden in China highlights the urgent need for strengthened tobacco control, improved screening, especially among the elderly, and addressing environmental and occupational exposures. The study provides a basis for developing targeted public health strategies.