# Global, regional, and national temporal trends in mortality and disease burden of nasopharyngeal carcinoma attributable to smoking from 1990 to 2021 and predictions to 2040

## TL;DR

This study examines how smoking contributes to the global burden of nasopharyngeal carcinoma, finding significant regional and gender differences in mortality and disease burden from 1990 to 2021.

## Contribution

The study provides new global and regional trends in the disease burden of smoking-attributable nasopharyngeal carcinoma and future projections.

## Key findings

- In 2021, smoking-attributable NPC caused over 1.3 million years of life lost globally, with the highest burden in Asia.
- Males and middle-aged populations experienced a higher disease burden, though age-standardized rates declined for females and in diverse SDI regions.
- Projections suggest rising total deaths and burden, but declining age-standardized rates except for years lived with disability.

## Abstract

Smoking is a major environmental risk factor for nasopharyngeal carcinoma (NPC), but the global burden and epidemiological trends of NPC attributable to smoking remain unclear.

Data were obtained from the 2021 Global Burden of Disease study. A comprehensive analysis was conducted on mortality, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs) attributable to NPC attributable to smoking. Clustering analysis was applied to evaluate the variation patterns across 21 regions. The NORDPRED age-period-cohort model was used for prediction.

In 2021, there were 13410 deaths globally from NPC attributable to smoking, 10031 YLDs, 1379583 YLLs, and 389614 DALYs. The disease burden was most severe in Asia. Males bore a significantly higher burden than females, mainly concentrated in middle-aged and older populations. From 1990 to 2021, although the number of cases increased, ASRs showed a marked decline, particularly among females and in regions with both high and low sociodemographic index (SDI) levels. Regional analyses revealed significant reductions of the disease burden in Australasia and Western Europe. The 21 regions were divided into 4 groups based on changes in mortality, representing distinct variation patterns. Projections from 2022 to 2040 indicate that, while the total number of deaths and disease burden is expected to rise, ASRs are anticipated to decline except YLDs.

Smoking contributes significantly to the disease burden of NPC, posing a serious threat to public health. Targeted intervention strategies should be implemented according to the regional clustering results of disease burden.