Burden of laryngeal cancer in China caused by smoking from 1990 to 2021 and predictions for 2035: An age-period-cohort analysis of global burden of disease study 2021

TL;DR

This study examines how smoking has contributed to the rising burden of laryngeal cancer in China from 1990 to 2021 and predicts future trends up to 2035.

Contribution

The study provides new predictions for laryngeal cancer burden in China using age-period-cohort analysis and Bayesian modeling.

Findings

The burden of laryngeal cancer due to smoking increased in China, with more male deaths and DALYs than female.

Age-standardized rates declined, especially in females, despite rising absolute numbers.

Predictions show continued increases in deaths but decreasing age-standardized rates by 2035.

Abstract

Smoking is a major risk factor for laryngeal cancer (LC). Understanding the impact of smoking on the changing disease burden of LC is crucial for LC prevention in China and provides a scientific basis for formulating targeted LC prevention and control strategies, contributing to the achievement of the ‘Healthy China 2030’ goals.

Data on LC attributable to smoking in China, stratified by sex, age, and year, were obtained from the 2021 Global Burden of Disease (GBD) study to conduct a secondary data analysis. Joinpoint regression was used to analyze trends in the burden of LC attributable to smoking in China from 1990 to 2021. Age-period-cohort (APC) analysis was employed to compare and analyze trends in the age, period, and cohort effects on the disease burden. Finally, Bayesian age-period-cohort (BAPC) analysis was used to predict trends in LC mortality and disability-adjusted life years (DALYs) from 2022 to 2035.

From 1990 to 2021, the overall burden of LC attributable to smoking in China increased. The number of deaths in males rose from 9128 to 14219, and in females from 790 to 1054. DALYs increased by 39.85% in males and 22.21% in females. Despite the rise in absolute burden, age-standardized mortality rates (ASMR) and age-standardized DALY rates (ASDR) declined, with reductions exceeding 50% in females. Joinpoint regression analysis revealed a decline-stabilization-decline trend in age-standardized rates among males, while females exhibited a continuous decline. According to the APC model, the age effect on disease burden increased with age, while period and cohort risk ratios generally declined. Net drift analysis showed a decline in mortality and DALY rates attributable to smoking, more pronounced in females than males, with local drift values <0 for both sexes. Predictions indicate that by 2035, male LC deaths will reach 17205, and female deaths 1373; however, ASMR and ASDR will continue to decline, with male ASMR dropping to 2.44 per 100000 and female ASMR to 0.16 per 100000.

Over the past three decades, the burden of LC attributable to smoking in China has shown an increasing trend, with sex and age disparities. This burden is expected to continue rising over the next fourteen years. Therefore, it is imperative to strengthen smoking prevention and cessation efforts, particularly targeting high-risk groups. Additionally, continued emphasis on education and awareness regarding LC is necessary to facilitate early detection and intervention, thereby effectively reducing the disease burden attributable to smoking.

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