Tracheal, bronchus, and lung cancer among older adults: thirty-year global burden trends, precision medicine breakthroughs, and lingering barriers.

IF 3.4 2区 医学 Q2 ONCOLOGY
Hongquan Xing, Cong Wu, Weichang Yang, Shanshan Cai, Xinyi Zhang, Xiaoqun Ye
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Abstract

Background: Tracheal, bronchial, and lung (TBL) cancer presents significant health challenges for individuals aged 70 and older. However, comprehensive insights into the epidemiological patterns of and risk factors for TBL cancer in this population remain limited. This study aimed to analyze the global, regional, and national burdens and trends of TBL cancer patients aged ≥ 70 years from 1990-2021.

Methods: The incidence, mortality, and disability-adjusted life years (DALYs) for TBL cancer patients aged ≥ 70 years from 1990-2021 were obtained from the 2021 Global Burden of Disease study. Global trends were stratified age, sex, and sociodemographic index (SDI). Decomposition analysis identified the primary drivers of burden changes, and a global risk attribution analysis was conducted. The Bayesian Age‒Period‒Cohort (BAPC) model forecasted trends over the next 14 years. The analyses were performed with Joinpoint software and the R software.

Results: From 1990-2021, the ASIRs, ASMRs, and ASDRs of TBL cancer among patients ≥ 70 years increase significantly, mainly due to aging and population growth. In the precision medicine era (2015-2021), these indicators for both sexes and males have declined, but the burden among females has increased. The burden varies across regions, with the incidence of TBL cancer increasing more severely in middle-SDI regions, East Asia, and western sub-Saharan Africa, whereas high-SDI regions have shown a decline after peaking. Although the DALY proportion of smoking decreased, it was still the main cause of TBL cancer. However, the burden of environmental particulate pollution has increased. The BAPC model predicted that in the future, the ASIR, ASMR, and ASDR for males and both sexes would decrease, whereas these indicators would either remain stable or increase among females.

Conclusions: The burden of TBL cancer is increasing significantly among patients aged ≥ 70 years. Despite new hopes and approaches from precision medicine, environmental and behavioral factors still critically influence the TBL cancer burden. Future strategies could enhance subgroup-specific management and promote effective control of known risk factors.

老年人的气管、支气管和肺癌:三十年全球负担趋势、精准医学突破和挥之不去的障碍。
背景:气管、支气管和肺部(TBL)癌症对70岁及以上的个体构成了重大的健康挑战。然而,对这一人群中TBL癌症的流行病学模式和危险因素的全面了解仍然有限。本研究旨在分析1990-2021年全球、地区和国家≥70岁TBL癌症患者的负担和趋势。方法:从2021年全球疾病负担研究中获得1990-2021年年龄≥70岁TBL癌症患者的发病率、死亡率和残疾调整生命年(DALYs)。对全球趋势进行年龄、性别和社会人口指数(SDI)分层。分解分析确定了负担变化的主要驱动因素,并进行了全球风险归因分析。贝叶斯年龄-时期-队列(BAPC)模型预测了未来14年的趋势。采用Joinpoint软件和R软件进行分析。结果:1990-2021年,≥70岁TBL患者的asir、ASMRs和ASDRs显著增加,主要原因是老龄化和人口增长。进入精准医疗时代(2015-2021年),男性和性别的这些指标均有所下降,但女性的负担有所增加。各地区的负担各不相同,TBL癌症发病率在中等sdi地区、东亚和撒哈拉以南非洲西部的增加更为严重,而高sdi地区在达到峰值后出现下降。吸烟的DALY比例虽有所下降,但仍是TBL的主要发病原因。然而,环境颗粒物污染的负担有所增加。BAPC模型预测,未来男性和两性的ASIR、ASMR和ASDR都将下降,而女性的这些指标要么保持稳定,要么增加。结论:年龄≥70岁的TBL患者负担明显增加。尽管精准医学带来了新的希望和方法,但环境和行为因素仍然严重影响着TBL癌症负担。未来的战略可以加强针对亚群体的管理,促进对已知风险因素的有效控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Cancer
BMC Cancer 医学-肿瘤学
CiteScore
6.00
自引率
2.60%
发文量
1204
审稿时长
6.8 months
期刊介绍: BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
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