Trachea, bronchus, and lung cancer in women of reproductive age: global burden trends from 1990 to 2021 and forecasts to 2035.
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BACKGROUND: In recent decades, cancers of the trachea, bronchus and lung cancer (TBL) have been the cancers with the highest global morbidity and mortality rates, with large regional variations, and the highest economic burden of all cancer types, and have shown a clear trend towards feminisation and younger onset. Therefore, we aimed to provide comprehensive insights into the prevalence and impact of TBL in women of reproductive age, taking into account factors such as age and socio-demographic indices (SDI). METHODS: To assess trends in the prevalence of TBL among women of reproductive age, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to systematically assess the burden of CBD and its changes globally, regionally, and nationally from 1990 to 2021. We calculated estimated annual percentage change (EAPC), age-standardised incidence rates (ASIR), age-standardised death rates (ASDR) and disability-adjusted life years (DALYs) for 204 countries and regions from 1990 to 2021. DALYs were used as a measure in conjunction with socio-demographic indices (SDIs). Analyses include the Inequality Slope Index (ISI) and the Concentration Index (CI) to measure health inequalities, frontier analyses to estimate achievable outcomes based on levels of development, decomposition analyses to identify drivers of change in the burden of disease, analysis of yearly cyclical cohort models, and Bayesian age-period-cohort (BAPC) modelling to predict future trends in the burden of disease. RESULTS: Compared with 1990, there was an increase in global morbidity and mortality from TBL in women of childbearing age in 2021, but there was a decrease in global morbidity and mortality, with the most pronounced downward trend in TBL in women of childbearing age in the 45-49 age group. In contrast, the global rate of DALYs increased, and the highest rate of DALYs in women of reproductive age was found in the 45-49 age group. Only low-SDI regions and medium-low-SDI regions had increased incidence and mortality rates of the 21 GBD regions, East Asia had the highest incidence and mortality rates of the 204 countries, Nigeria had the lowest incidence and mortality rates, Greenland had the highest incidence rates, and Monaco had the highest mortality rates in 2021. From 1990 to 2021, absolute and relative inequality associated with the socio-demographic index (SDI) decreases, but inequality persists. Projections of ASR for women of childbearing age from 2021 to 2035 found an overall declining trend in TBL ASIR and ASMR for women of childbearing age from 2021 onwards. CONCLUSION: Although the global age-standardised DALY rates for ASIR, ASDR and TBL in women of reproductive age have decreased over the past three decades, the global burden of TBL is unevenly distributed. Moreover, the prevention and control of TBL in women of reproductive age require international cooperation, multisectoral collaboration, government support, and the joint efforts of women themselves and their families and societies.