Lung cancer mortality in the wake of the changing smoking epidemic: a descriptive study of the global burden in 2020 and 2040

Abstract Objectives Lung cancer is the leading cause of cancer death in 2020, responsible for almost one in five (18.0%) deaths. This paper provides an overview of the descriptive epidemiology of lung cancer on the basis of national mortality estimates for 2020 from the International Agency for Research on Cancer (IARC), and in the context of recent tobacco control policies. Methods Age-standardized mortality rates per 100,000 person-years of lung cancer for 185 countries by sex were obtained from the GLOBOCAN 2020 database and stratified by Human Development Index (HDI). Lung cancer deaths were projected to 2040 based on demographic changes alongside scenarios of annually increasing, stable or decreasing rates from the baseline year of 2020. Results Lung cancer mortality rates exhibited marked variations by geography and sex. Low HDI countries, many of them within sub-Saharan Africa, tend to have low levels of mortality and an upward trend in lung cancer deaths is predicted for both sexes until 2040 according to demographic projections, irrespective of trends in rates. In very high HDI countries, including Europe, Northern America and Australia/New Zealand, there are broadly decreasing trends in men whereas in women, rates are still increasing or reaching a plateau. Conclusion The current and future burden of lung cancer in a country or region largely depends on the present trajectory of the smoking epidemic in its constituent populations, with distinct gender differences in smoking patterns, both in transitioning and transitioned countries. Further elevations in lung cancer mortality are expected worldwide, raising important social and political questions, especially in low- and middle-income countries. Strengths and limitations of this study Strengths This study presents a detailed profile of the present LC burden in men and women worldwide according to national levels of human development. applies a simple projection to estimate the future lung cancer mortality burden in 2040. discusses the results in the context of key risk factors for lung cancer, particularly the continually evolving smoking epidemic. Limitations This study is hampered by the limited availability of local cause of death information from national vital registration sources, particularly in transitioning countries.