Objective: This study examined geographic patterns, temporal trends, and determinants of tracheal, bronchus, and lung (TBL) cancer burden in Asia (1990-2023), evaluated disparities in health outcomes, and developed projections for targeted prevention initiatives.
Methods: Data were obtained from the Global Burden of Disease Study 2023. We estimated age-standardized rates (ASPR, ASIR, ASMR, ASDR). Joinpoint regression assessed temporal trends; age-period-cohort and Das Gupta analyses identified underlying mechanisms and drivers. Data envelopment analysis (DEA) evaluated efficiency relative to the Human Development Index (HDI). Health inequalities were measured with the slope index of inequality (SII) and concentration index (CI). Bayesian age-period-cohort (BAPC) modeling projected trends to 2038.
Results: Asian populations experienced 2.05 million prevalent cases, 1.40 million incident cases, 1.26 million fatalities, and 29.45 million DALYs in 2023. East Asia had the highest burden. From 1990 to 2023, ASPR increased, while ASMR and ASDR declined. Males and older adults carried disproportionately higher burdens. Decomposition analysis revealed that epidemiological changes and population growth were the major contributors. Inequality worsened, with SII rising from 275.8 to 311.6 and CI consistently negative, indicating concentration in low-HDI regions. Projections suggested further increases in ASPR (+28.7%) and ASIR (+21.6%) by 2038.
Conclusion: The TBL cancer burden in Asia is rising, with marked regional, gender, age disparities and deteriorating health equity. East Asia is most affected. Targeted strategies, including enhanced early screening in high-burden areas and improved healthcare accessibility in low-HDI regions, are essential to reduce the disease burden and promote equity.
Keywords: Asian epidemiology; TBL cancer; disease burden; health inequality; prediction model; trend analysis.