To analyze the epidemiological trends of lung cancer in China and the world from 1990 to 2021, and to predict future standardized morbidity and mortality. By assessing the key factors affecting the burden of lung cancer, such as age, time period and birth cohort, the aim is to reveal the risk patterns of morbidity and mortality in different groups, provide a scientific basis for lung cancer prevention and control strategies, and support disease prevention, early intervention and resource allocation optimization.

The data of this study were from the Global Burden of Disease 2021 (GBD 2021) database. Statistical analysis was performed using R 4.4.1 software. The annual percent change (APC) and average annual percent change (AAPC) were calculated by Joinpoint regression model to evaluate the trend of lung cancer incidence and mortality. At the same time, the age-period-cohort model combined with the endogenous factor algorithm (IE) was used to decompose and analyze the age, period and cohort effects, and to evaluate the independent effects of each factor on the risk of morbidity and mortality.

From 1990 to 2021, the average annual standardized incidence of lung cancer in China increased by 0.95%(95%CI: 0.76%-1.13%, P<0.001 ), and the average annual standardized mortality increased by 0.38%(95%CI: 0.13% -0.63%, P=0.003). The global standardized incidence of lung cancer decreased by 0.25%(95%CI: -0.36% -0.13%, P<0.001), and the global standardized mortality decreased by 0.54 %(95%CI: -0.7% -0.37%, P<0.001). It is estimated that the overall standardized incidence of lung cancer in China will decrease to 57.78/100 000 by 2044.It is estimated that the overall standardized incidence of lung cancer in China will decrease to 57.78/100 000 by 2044. The standardized incidence rate of male decreased to 73.59/100 000, and the standardized incidence rate of female increased to 44.80/100 000. The global standardized incidence of lung cancer decreased to 29.82/100 000. During the same period, the overall standardized mortality rate of lung cancer in China decreased to 48.23/100 000. The standardized mortality rate of males decreased to 62.88/100 000, while that of females increased to 36.18/100 000. From 1990 to 2021, the RR value of the period change of lung cancer incidence in China increased year by year, and the RR value of the period change of mortality increased first and then decreased. The cohort effect of lung cancer incidence and mortality also showed a trend of increasing first and then decreasing.

From 1990 to 2021, the incidence and mortality of lung cancer in China continued to rise, while the world showed a downward trend. The incidence and mortality of lung cancer increased with age, and men were significantly higher than women. The period effect increased year by year, and the cohort effect increased first and then decreased. The prediction shows that the incidence and mortality of lung cancer in China and the world will decline as a whole from 2022 to 2044, and the global data is positively correlated with SDI.