# Global, Regional, and National Burden of Tracheal, Bronchial, and Lung Cancer Attributable to Low Fruit Intake From 1990 to 2021

## TL;DR

This study shows that low fruit intake contributes to lung cancer deaths and disability worldwide, especially in lower-income regions.

## Contribution

Quantifies the global, regional, and national burden of lung cancer linked to low fruit consumption from 1990 to 2021.

## Key findings

- Low fruit intake caused 66,045 deaths and 1.6 million DALYs globally in 2021.
- Middle and low-middle SDI regions had the highest disease burden from low fruit intake.
- Global rates of lung cancer burden from low fruit intake declined from 1990 to 2021.

## Abstract

Low fruit intake has been identified as a significant modifiable risk factor for tracheal, bronchial, and lung (TBL) cancer. This study aims to quantify the global, regional, and national burden of TBL cancer attributable to low fruit intake from 1990 to 2021.

Using data from the Global Burden of Disease (GBD) 2021, this descriptive epidemiological study analyzed deaths, disability‐adjusted life years (DALYs), and age‐standardized rates (ASMR and ASDR) attributable to low fruit intake (< 340–350 g/day). Temporal trends were assessed using estimated annual percentage changes (EAPC), and decomposition analyses identified the contributions of aging, population growth, and epidemiological changes to disease burden.

In 2021, low fruit intake caused 66,045 deaths and 1,611,267 DALYs globally, with higher burdens in males. The middle socio‐demographic index (SDI) region recorded the greatest number of deaths and DALYs, while the low‐middle SDI region had the highest ASMR (0.84, 95% uncertainty interval [UI]: 0.44 to 1.18) and ASDR (21.96, 95% UI: 11.39 to 30.93). Temporal trends showed a global decline in ASMR (estimated annual percentage change [EAPC] = −1.89, 95% CI: −1.96 to −1.81) and ASDR (EAPC = −2.23, 95% CI: −2.32 to −2.14) from 1990 to 2021, although increases persisted in some low‐SDI regions. Aging and population growth were major contributors to DALY increases, despite improvements in epidemiological factors.

Low fruit intake significantly contributes to the global TBL cancer burden. Promoting fruit consumption, particularly in low‐SDI regions, is critical for reducing this preventable burden through integrated public health strategies.