Background

Lung cancer ranks second for cancer incidence and first for cancer mortality. Investigation into its risk factors and epidemiologic trends could help describe geographical distribution and identify high-risk population groups.

Research Question

What is the global incidence, mortality, associated risk factors, and temporal trends of lung cancer by sex, age, and country?

Study Design and Methods

Data on incidence and mortality were retrieved from the Global Cancer Observatory (GLOBOCAN), Cancer Incidence in Five Continents series I-X, World Health Organization (WHO) mortality database, the Nordic Cancer Registries (NORDCAN), and the Surveillance, Epidemiology, and End Results Program (SEER). We searched the WHO Global Health Observatory data repository for age-adjusted prevalence of current smoking. The Average Annual Percentage Change (AAPC) of the trends were obtained by Joinpoint Regression.

Results

The age-standardized rate of incidence and mortality were 22.4 and 18.0 per 100,000 globally. The lung cancer incidence and mortality were associated with Human Development Index (HDI), Gross Domestic Products (GDP), and prevalence of smoking. For incidence, more countries had increasing trends in females but decreasing trends in males (AAPC, 1.06 to 6.43 for female; −3.53 to −0.64 for male). A similar pattern was found in those 50 years or older, whereas those aged younger than 50 years had declining incidence trends in both sexes in most countries. For mortality, similar to incidence, 17 of 48 countries showed decreasing trends in males and increasing trends in females (AAPC, −3.28 to −1.32 for male, 0.63 to 3.96 for female).

Interpretation

Most countries had increasing trends in females but decreasing trends in males and in lung cancer incidence and mortality. Tobacco related measures and early cancer detection should be implemented to control the increasing trends of lung cancer in females, and in regions identified as having these trends. Future studies may explore the reasons behind these epidemiological transitions.

中文翻译：

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肺癌发病率和死亡率的分布、危险因素和时间趋势

背景

肺癌在癌症发病率中排名第二，在癌症死亡率方面排名第一。对其风险因素和流行病学趋势的调查有助于描述地理分布和识别高危人群。

研究问题

按性别、年龄和国家划分的肺癌的全球发病率、死亡率、相关危险因素和时间趋势如何？

研究设计和方法

发病率和死亡率数据来自全球癌症观察站 (GLOBOCAN)、五大洲癌症发病率系列 IX、世界卫生组织 (WHO) 死亡率数据库、北欧癌症登记处 (NORDCAN) 以及监测、流行病学和最终结果程序（SEER）。我们搜索了世卫组织全球卫生观察站数据存储库，以了解经年龄调整的当前吸烟率。趋势的平均年度百分比变化 (AAPC) 是通过 Joinpoint 回归获得的。

结果

全球年龄标准化的发病率和死亡率分别为 22.4 和 18.0/100,000。肺癌发病率和死亡率与人类发展指数（HDI）、国内生产总值（GDP）和吸烟率相关。对于发病率，更多国家的女性呈上升趋势，但男性呈下降趋势（AAPC，女性为 1.06 至 6.43；男性为 -3.53 至 -0.64）。在 50 岁或以上的人群中发现了类似的模式，而在大多数国家，50 岁以下的人群中男女发病率呈下降趋势。在死亡率方面，与发病率相似，48 个国家中有 17 个国家的男性呈下降趋势，女性呈上升趋势（AAPC，男性为 -3.28 至 -1.32，女性为 0.63 至 3.96）。

解释

大多数国家的女性发病率和死亡率呈上升趋势，但男性发病率和死亡率呈下降趋势。应实施与烟草相关的措施和早期癌症检测，以控制女性肺癌的增加趋势，以及在确定有这些趋势的地区。未来的研究可能会探索这些流行病学转变背后的原因。