JMIR Publications

ABSTRACT

Background:

Lung cancer is the leading cause of cancer deaths worldwide, with 2,206,771 new lung cancer cases and 1,796,144 deaths in 2020. Many studies showed tremendous effort in the discovery of potential biomarkers for the detection, classification and progression monitoring of lung cancer. The treatment of lung cancer has made great progress over the past decade. The study on the long-term changes of disease burden of lung cancer has great exploratiory significance to further clarify the epidemiological characteristics of lung cancer and improve the survival time of patients

Objective:

The study in the long-term changes in premature death of lung cancer in a developed region of China has a great exploratiory significance to further clarify the effectiveness of intervention measures

Methods:

Cancer death data were collected from the Mortality Registration System of Shanghai Pudong New Area (PNA). We analysed crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of lung cancer from 1973 to 2019. Temporal trends of CMR, ASMRW, and rate of YLL were calculated by joinpoint regression expressed as an annual percent change (APC) with corresponding 95% confidence interval.

Results:

80,543,137 person-years were enrolled in this study in PNA from 1973 to 2019. There were 42,229 deaths in permanent residents from lung cancer. The CMR and ASMRW were 52.43/105 person-years and 27.79/105 person-years. YLL due to premature death from lung cancer was 481779.14 years, and the rate of YLL was 598.16/105 person-years. The CMR, and rate of YLL for deaths had significantly increasing trends in males, females, and the total population (P<0.001). The CMR in the total population increased by 2.86% (95% CI=2.66%-3.07%, P < 0.001) per year during the study period. The YLL rate increased with an APCC of 2.21% (95% CI = 1.92% to 2.51%, P < 0.001) per year. The contribution rates of increased values of CMR caused by demographic factors were more evident than non-demographic factors.

Conclusions:

The aging population, progress of treatment, smoking, and even environmental pollution may be the factors that affect the long-term changes in premature death of lung cancer in PNA from1973 to 2019. Our research can help us to understand the changes of lung cancer mortality, and our results could also be used for other similar cities in designing future prevention plans.