Global trends and cross-country inequalities in laryngeal cancer: A systematic analysis of the 2021 Global Burden of Disease study represented by China.

Abstract

Introduction: Laryngeal cancer is one of the most common malignant tumors in the upper respiratory tract, accounting for approximately 4.5% of all malignant tumors. Smoking, drinking alcohol and occupational exposure are its main risk factors. Based on the Global Burden of Disease (GBD) database from 1990 to 2021, this study conducted a comparative analysis of laryngeal cancer-related data in China and around the world.

Methods: This is a secondary dataset analysis based on the Global Burden of Disease Study 2021. Chinese and global laryngeal cancer data for the period from 1990 to 2021 were extracted from the GBD database, and the Joinpoint regression model was used to analyze age-standardized incidence, prevalence, mortality, and DALYs. The inequality slope index (SII) and concentration index were calculated to assess health inequalities and risk factor attribution analysis was performed. Finally, a Bayesian hierarchical modeling method was used to predict the laryngeal cancer burden from 2022 to 2050.

Results: From 1990 to 2021, the ASPR in China increased from 7.83 per 100000 people to 9.86, while the ASIR in the world decreased from 15.27 per 100000 people to 12.56, showing an opposite trend. The global inequality index (SII) shows a downward trend but is still greater than 0 (SII was 3.70 in 2021), and the concentration index has changed from -0.23 to -0.13, indicating that health problems related to laryngeal cancer are concentrated in poor countries, but the inequality between poor and rich countries is narrowing. Among women in high-income countries, the attributed deaths caused by tobacco and alcohol consumption are 58.5% and 9.8%, respectively, which are much higher than the global average of 30.9% and 3%. The attributable proportions of DALYs caused by tobacco and alcohol consumption were 61.5% and 10.7%, respectively, which were much higher than the global average proportions of 29% and 3.1%. It is estimated that by 2050, the global incidence rate of laryngeal cancer will decrease to 2.020 per 100000 people, the mortality rate will decrease to 1.028 per 100000 people, the cancer incidence rate among Chinese men will be 0.453 per 100000 people, and the ASMR will decrease to 0.173 per 100000 people.

Conclusions: The global burden of laryngeal cancer decreased overall from 1990 to 2021, but the incidence and prevalence in China are complex and may be influenced by urbanization and lifestyle changes. The incidence of laryngeal cancer in Chinese women continues to rise, which is worthy of attention. Low-income countries face greater challenges, where digital health technologies can help with early screening and treatment.