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. 2021 Apr 15;13(4):1928-1951.
eCollection 2021.

Tracheal, bronchus, and lung cancer burden and related risk factors in the United States and China

Yujiao Deng  1   2 , Ling Peng  3 , Na Li  1   2 , Zhen Zhai  1   2 , Dong Xiang  4 , Xianghua Ye  3 , Jingjing Hu  5 , Yi Zheng  1   2 , Jia Yao  1 , Shuqian Wang  1 , Bajin Wei  1 , Peng Xu  1   2 , Dai Zhang  1   2 , Tianhui Chen  6 , Zhijun Dai  1   2
Affiliations

Tracheal, bronchus, and lung cancer burden and related risk factors in the United States and China

Yujiao Deng et al. Am J Transl Res. .

Abstract

Tracheal, bronchus, and lung (TBL) cancer is the most common malignant tumor worldwide. This study aims to grasp the characteristics of the TBL cancer burden in China and the United States (USA). Data included incidence, deaths, and disability-adjusted life years (DALYs) as well as their age-standardized rates (ASRs) among different gender, age and risk factors. Joinpoint Regression Model and Age-period-cohort (APC) analysis were used to evaluate the variation tendency and effect of the risk factors. China and USA bore almost half of the TBL cancer burden, especially for males. ASRs of TBL cancer increased in China, but decreased in USA. In China, three factors related to TBL cancer deaths and DALYs related were tobacco, air pollution, and diet low in fruits; in USA, these are tobacco, occupational carcinogens, and high fasting plasma glucose. The younger the population, the less impact of birth cohort on morbidity and mortality. According to APC analysis, age effect played a key role in morbidity and mortality of TBL cancer, and the risk increased with age. Period effect kept increasing over time, while cohort effect decreased with the time of birth. Tobacco was always the top risk factor of death and DALYs in both countries. The policy should be tilted towards air pollution and a diet low in fruits in China, as well as occupational carcinogens and high fasting plasma glucose in USA. Healthcare reform in both countries should focus on planning how its health system could effectively prevent and manage TBL cancer at low cost.

Keywords: Age-period-cohort model; GBD study; bronchus; joinpoint regression; lung cancer; risk factors; tracheal.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
The distribution of TBL cancer burden in 2017 worldwide. A. Incidents; B. Deaths; C. DALYs. DALY, disability adjusted life-year.
Figure 2
Figure 2
TBL cancer burden of three age groups in both countries over 28 years. A. Incidents; B. Deaths; C. DALYs. DALY, disability adjusted life-year.
Figure 3
Figure 3
TBL cancer burden of three age groups among females in both countries over 28 years. A. Incidents; B. Deaths; C. DALYs. DALY: disability adjusted life-year.
Figure 4
Figure 4
TBL cancer burden of three age groups among males in both countries over 28 years. A. Incidents; B. Deaths; C. DALYs. DALY: disability adjusted life-year.
Figure 5
Figure 5
The variation trend of ASDR (per 100,000 people) of six risks in different genders over 28 years. A. Both gender; B. Females; C. Males. ASDR, age standardized death rate.
Figure 6
Figure 6
The variation trend of age standardized DALY rate (per 100,000 people) of six risks in different genders over 28 years. A. Both gender; B. Females; C. Males. DALY, disability adjusted life-year.
Figure 7
Figure 7
The variation trend of death rate (per 100,000 people) of eight risks in different genders and age groups. A. Both gender; B. Females; C. Males.
Figure 8
Figure 8
The variation trend of DALY rate (per 100,000 people) of eight risks in different genders and age groups. A. Both gender; B. Females; C. Males. DALY, disability adjusted life-year.
Figure 9
Figure 9
Comparison of APC model analysis on TBL cancer morbidity risk between China and USA. A. Both gender; B. Females; C. Males. APC model, Age-Period-Cohort Model.
Figure 10
Figure 10
Comparison of APC model analysis on TBL cancer mortality risk between China and USA. A. Both gender; B. Females; C. Males. APC model, Age-Period-Cohort Model.
Figure 11
Figure 11
Comparison of APC model analysis on TBL cancer morbidity and mortality risk between females and males. A. Morbidity in China; B. Mortality in China; C. Morbidity in USA; D. Mortality in USA. APC model, Age-Period-Cohort Model.
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