Abstract
INTRODUCTION: Lung cancer is a significant health issue in the Western Pacific region, where tobacco use is highly prevalent. This study examines the trends in tobacco-related lung cancer burden from 1990 to 2021, offering insights into the evolution of this critical public health challenge. METHODS: This study uses data from the Global Burden of Disease (GBD) 2021 study to analyze lung cancer rates. It employs an age-period-cohort analysis to explore patterns in mortality and disability-adjusted life-years (DALYs) attributed to tobacco-related lung cancer. The study also uses joinpoint regression analysis to pinpoint changes over different periods. RESULTS: Our analyses revealed a substantial rise in both the number of deaths and DALYs due to tobacco-related lung cancer in the Western Pacific region from 1990 to 2021. Total deaths increased by 163.42% to 644.5 thousand (95% UI: 517.9-793.8) in 2021, which is 2.6 times the global growth rate of 63.25%. While global ASMR decreased by 25.46%, the Western Pacific Region showed minimal change with a slight increase (AAPC=0.08). SDI analysis revealed an inverse relationship with burden - for example, Singapore's ASMR decreased from 20.4 to 7.0 per 100000 population (high SDI) while China's increased from 23.8 to 25.8 (middle SDI). Age-period-cohort analysis showed the net drift of lung cancer mortality was -0.16% per year. The fastest increase in ASMR occurred between 1998-2004 (APC=1.53%), followed by the steepest decline during 2004-2007 (APC= -1.49%). CONCLUSIONS: The Western Pacific region continues to face a high burden of tobacco-related lung cancer.