Analysis of the disease burden and trends of tracheal, bronchus, and lung cancer attributable to occupational carcinogens 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 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 reference 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, DALYs rate, age-standardized mortality rate, and age-standardized DALYs 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 000in 2021, respectively. The growth rates were 182.16%, 139.74%, 32.20%, and 20.58%, respectively. Joinpoint regression analysis showed that the AAPC values of overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs 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<0.001), 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 DALYs rate showed a trend of increasing first and then slowly decreasing with age, peaking at 65-69 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, DALYs rate, age-standardized mortality rate, and age-standardized DALYs 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, DALYs rate, age-standardized mortality rate, and age-standardized DALYs 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, DALYs rate, age-standardized mortality rate, and age-standardized DALYs 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.

Citation： LI Fu, ZHANG Yanan, LIU Bin, HU Shoucai, LONG Hai, MA Linchong, HU Gawei, LI Qingxin. Analysis of the disease burden and trends of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in China from 1990 to 2021. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(9): 1263-1270. doi: 10.7507/1007-4848.202501016 Copy

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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: 158-165.
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, 張永輝, 等. 1990—2019年中國歸因于吸煙的肺癌疾病負擔研究. 現代腫瘤醫學, 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. 馬運, 袁浩冉, 胡昊, 等. 1990—2019年中國歸因于煙草的肺癌疾病負擔變化趨勢分析. 現代預防醫學, 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-A727.
8. 胡守財, 陶堰成, 馬浩天, 等. 1990—2019年中國非風濕性瓣膜性心臟病疾病負擔及變化趨勢分析. 中國循環雜志, 2024, 39(8): 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(8): 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. 馬一楷, 王耿, 劉彩霞. 1990—2019年中國歸因于吸煙因素的食管癌疾病負擔分析. 中山大學學報(醫學科學版), 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. 吳霞, 張譯勻, 姚承志, 等. 1990—2021年中國歸因于飲食因素的缺血性心臟病疾病負擔變化趨勢及預測研究. 中國全科醫學, 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. 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.
14. Huang JC. Application of grey system theory in telecare. Comput Biol Med, 2011, 41(5): 302-306.
15. 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.
16. 劉智, 羅長春, 李超, 等. 1990—2021年中國矽肺疾病負擔研究. 公共衛生與預防醫學, 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.
17. 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.
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: 158-165.
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

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

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