Analysis of the burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens and trends in China from 1990 to 2021_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Fu ^1,2,3 , ZHANG Yanan ^1,2,3 , LIU Bin ^1,2,3 , HU Shoucai ^1,2,3 , LONG Hai ⁴ , MA Linchong ^2,3 ,  HU Gawei ^2,3 ,  LI Qingxin ^2,3

1. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;
2. Department of General Thoracic Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, 730000, P. R. China;
3. Department of Plateau Medicine, The 940th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, 730000, P. R. China;
4. Thoracic Tumor Center, Department of Thoracic Surgery, Northeast Yunnan Central Hospital, Zhaotong, 657000, Yunnan, P. R. China;

Corresponding author：

HU Gawei, Email: 371694464@qq.com; LI Qingxin, Email: liqxchest@163.com

Keywords：

Occupational carcinogens; trachea; bronchus; lung cancer; disease burden; trends; Joinpoint analysis

DOI：

10.7507/1007-4848.202501016

Video：

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Objective To analyze the disease burden and trends of tracheal, bronchus, and lung cancer (TBL) attributable to occupational carcinogens in China from 1990 to 2021, in order to provide parameters for the prevention and control of TBL in China. Methods Based on the Global Burden of Disease database 2021, with occupational carcinogens as relevant risk factors and tracheal, bronchus, and lung cancer as the study diseases, data on mortality and disability-adjusted life years (DALYs) attributable to occupational carcinogens in China from 1990 to 2021 were extracted and age-standardized. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC). Hiplot was used to visualize the distribution of disease burden by gender and age. The grey model GM (1,1) was used to predict the disease burden and trends of TBL attributable to occupational carcinogens in China from 2022 to 2031. Results From 1990 to 2021, the overall mortality rate, DALY rate, age-standardized mortality rate, and age-standardized DALY rate of TBL attributable to occupational carcinogens in China increased from 1.85/100 000, 53.93/100 000, 2.64/100 000, and 69.50/100 000 in 1990 to 5.22/100 000, 129.29/100 000, 3.49/100 000, and 83.80/100 000 in 2021, respectively. The increases were 181.62%, 139.77%, 32.40%, and 20.59%, respectively. Joinpoint regression analysis showed that the AAPC values of overall mortality rate, DALY rate, age-standardized mortality rate, and age-standardized DALY rate of TBL attributable to occupational carcinogens in China from 1990 to 2021 were 3.41%, 2.87%, 0.92%, and 0.62%, respectively (all P<0.05), showing an overall upward trend, with higher values in females than in males. In 2021, the overall mortality rate of TBL attributable to occupational carcinogens in China gradually increased with age, with high mortality rates mainly concentrated in those aged>65 years, and higher rates in males than in females. The overall DALY rate showed a trend of increasing first and then slowly decreasing with age, peaking at 65-74 years old, with higher rates in males than in females. The grey prediction model GM (1,1) showed that the predicted values of mortality rate, DALY rate, age-standardized mortality rate, and age-standardized DALY rate of TBL attributable to occupational carcinogens in China from 2022 to 2031 all showed an upward trend. By 2031, the predicted values of mortality rate, DALY rate, age-standardized mortality rate, and age-standardized DALY rate will reach 7.19/100 000, 175.63/100 000, 4.16/100 000, and 93.64/100 000, respectively. Conclusion From 1990 to 2021, the mortality rate, DALY rate, age-standardized mortality rate, and age-standardized DALY rate of TBL attributable to occupational carcinogens in China all showed an upward trend. Males and the elderly are the main populations affected by the disease burden of TBL attributable to occupational carcinogens in China. It is necessary to strengthen the prevention and control of occupational carcinogens and promote health education.

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19.	Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: A time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
20.	Costa SNL, Fernandes FCGM, Santos CAD, et al. Gender and regional differences in lung cancer mortality in Brazil. Asian Pac J Cancer Prev, 2020, 21(4): 919-926.
21.	Coultas DB, Samet JM. Occupational lung cancer. Clin Chest Med, 1992, 13(2): 341-354.
22.	Fulop T, Kotb R, Fortin CF, et al. Potential role of immunosenescence in cancer development. Ann N Y Acad Sci, 2010, 1197: 158-65.
23.	Brusletto B, Nielsen RA, Engan H, et al. Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study. Scand J Public Health, 2021, 49(2): 188-196.
24.	Wang C, Wu Z, Xu Y, et al. Disparities in the global burden of tracheal, bronchus, and lung cancer from 1990 to 2019. Chin Med J Pulm Crit Care Med, 2023, 1(1): 36-45.
25.	Kocarnik JM, Compton K, Dean FE, et al. Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. JAMA Oncol, 2022, 8(3): 420-444.

1. Nasim F, Sabath BF, Eapen GA. Lung cancer. Med Clin North Am, 2019, 103(3): 463-473.
2. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
3. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
4. 丁璐璐, 朱健, 张永辉, 等. 1990-2019年中国归因于吸烟的肺癌疾病负担研究. 现代肿瘤医学, 2024, 32(1): 141-146.Ding LL, Zhu J, Zhang YH, et al. Disease burden of lung cancer attributable to smoking in China from 1990 to 2019. Mod Oncol, 2024, 32(1): 141-146.
5. 马运, 袁浩冉, 胡昊, 等. 1990—2019年中国归因于烟草的肺癌疾病负担变化趋势分析. 现代预防医学, 2024, 51(8): 1345-1351.Ma Y, Yuan HR, Hu H, et al. Trend of disease burden of lung cancer attributed to tobacco in China, 1990-2019. Mod Prev Med, 2024, 51(8): 1345-1351.
6. Siemiatycki J, Richardson L, Straif K, et al. Listing occupational carcinogens. Environ Health Perspect, 2004, 112(15): 1447-1459.
7. Mild KH, Mattsso MO, Hardell L, et al. Occupational carcinogens: ELF MFs. Environ Health Perspect, 2005, 113(11): A726-727.
8. 胡守财, 陶堰成, 马浩天, 等. 1990~2019年中国非风湿性瓣膜性心脏病疾病负担及变化趋势分析. 中国循环杂志, 2024, 39(08): 806-812.Hu SC, Tao YC, Ma HT, et al. Disease burden and changing trend of Non-rheumatic Valvular Heart Disease from 1990 to 2019 in China. Chin Circ J, 2024, 39(08): 806-812.
9. GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990—2021: A systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2100-2132.
10. 马一楷, 王耿, 刘彩霞. 1990—2019年中国归因于吸烟因素的食管癌疾病负担分析. 中山大学学报(医学科学版), 2024, 45(4): 593-601.Ma YK, Wang G, Liu CX. Disease burden of Esophageal Cancer attributable to smoking from 1990 to 2019 in China. J Sun Yat-Sen Univ (Med Sci), 2024, 45(4): 593-601.
11. Tichenor M, Sridhar D. Metric partnerships: Global burden of disease estimates within the World Bank, the World Health Organisation and the Institute for Health Metrics and Evaluation. Wellcome Open Res, 2019, 4: 35.
12. 吴霞, 张译匀, 姚承志, 等. 1990-2021年中国归因于饮食因素的缺血性心脏病疾病负担变化趋势及预测研究. 中国全科医学, 2025, 28(3): 305-312.Wu X, Zhang YY, Yao CZ, et al. Trend and prediction of changes in the disease burden of diet-related Ischemic Heart Disease in China, 1990—2021. Chin Gen Pract, 2025, 28(3): 305-312.
13. GBD 2017 Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1684-1735.
14. 刘智, 罗长春, 李超, 等. 1990—2021年中国矽肺疾病负担研究. 公共卫生与预防医学, 2024, 35(6): 16-20.Liu Z, Luo CC, Li C, et al. Study on the burden of silicosis in China in 1990-2021. J Pub Health Prev Med, 2024, 35(6): 16-20.
15. Yi X, He Y, Zhang Y, et al. Current status, trends, and predictions in the burden of silicosis in 204 countries and territories from 1990 to 2019. Front Public Health, 2023, 11: 1216924.
16. Yang X, Zou J, Kong D, et al. The analysis of GM (1, 1) grey model to predict the incidence trend of typhoid and paratyphoid fevers in Wuhan City, China. Medicine (Baltimore), 2018, 97(34): e11787.
17. Huang JC. Application of grey system theory in telecare. Comput Biol Med, 2011, 41(5): 302-306.
18. Bade BC, Dela Cruz CS. Lung cancer 2020: Epidemiology, etiology, and prevention. Clin Chest Med, 2020, 41(1): 1-24.
19. Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: A time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
20. Costa SNL, Fernandes FCGM, Santos CAD, et al. Gender and regional differences in lung cancer mortality in Brazil. Asian Pac J Cancer Prev, 2020, 21(4): 919-926.
21. Coultas DB, Samet JM. Occupational lung cancer. Clin Chest Med, 1992, 13(2): 341-354.
22. Fulop T, Kotb R, Fortin CF, et al. Potential role of immunosenescence in cancer development. Ann N Y Acad Sci, 2010, 1197: 158-65.
23. Brusletto B, Nielsen RA, Engan H, et al. Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study. Scand J Public Health, 2021, 49(2): 188-196.
24. Wang C, Wu Z, Xu Y, et al. Disparities in the global burden of tracheal, bronchus, and lung cancer from 1990 to 2019. Chin Med J Pulm Crit Care Med, 2023, 1(1): 36-45.
25. Kocarnik JM, Compton K, Dean FE, et al. Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. JAMA Oncol, 2022, 8(3): 420-444.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesAnalysis of the burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens and trends in China from 1990 to 2021

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