Abstract
BACKGROUND: This study aimed to investigate the spatial and temporal variations of tracheal, bronchus, and lung cancer (TBLC) attributable to particulate matter pollution across 34 Asian countries and territories from 1990 to 2021. METHODS: Disability-adjusted life years (DALYs) linked to ambient particulate-matter pollution (APMP) and household air pollution (HAP) were obtained from the Global Burden of Disease (GBD) 2021 dataset, and performed analyses stratified by location, gender, and age. Trends in age-standardized DALY rates (ASDRs) were quantified with Joinpoint regression. Decomposition analysis was applied to identify the contributions of population aging, population growth, and epidemiological changes to the alterations in DALYs. RESULTS: From 1990 to 2021, APMP-related ASDR increased significantly in Asia, while HAP-related ASDR declined. In 2021, East Asia recorded the greatest APMP-associated DALYs across five GBD regions, while both South Asia and East Asia bore the heaviest HAP-related burden. China reported the highest absolute DALYs for each pollutant. Population aging and growth accounted for most of the increase in APMP-related DALYs in Asia, whereas epidemiological change chiefly explained the reduction in HAP-related DALYs. ASDRs were consistently higher in males, with wider sex disparities for APMP-related ASDR. Middle-aged and older adult populations were the most vulnerable age groups. CONCLUSION: Although TBLC burden attributable to HAP has fallen, disease linked to APMP remains a pressing public-health concern. Coordinated regional action and targeted interventions, particularly for men and older individuals, are essential to reduce pollution-driven TBLC across Asia.