Global, regional and national burden of lung cancer attributable to PM2.5 air pollution: Trends from 1990 to 2021 with projections to 2045

Yingfan Deng; Zengbin Li; Pan Zhang; Yang Yang; Yuhan Xie; Yutong Cheng; Shuiyan Yu; Guixian Zhu; Lili Han; Lijun Jia; Wentao Xi; Pei Wang; Mingwang Shen; Lingqin Song

doi:10.1016/j.jenvman.2025.126216

Global, regional and national burden of lung cancer attributable to PM_2.5 air pollution: Trends from 1990 to 2021 with projections to 2045

J Environ Manage. 2025 Jun 24:390:126216. doi: 10.1016/j.jenvman.2025.126216. Online ahead of print.

Authors

Yingfan Deng¹, Zengbin Li², Pan Zhang³, Yang Yang¹, Yuhan Xie⁴, Yutong Cheng³, Shuiyan Yu¹, Guixian Zhu⁵, Lili Han¹, Lijun Jia¹, Wentao Xi¹, Pei Wang¹, Mingwang Shen⁶, Lingqin Song⁷

Affiliations

¹ Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China.
² Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China. Electronic address: lizengbin98@126.com.
³ Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China.
⁴ Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China.
⁵ Department of Hematology, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China.
⁶ China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, 710061, China; The Interdisciplinary Center for Mathematics and Life Sciences, School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, 710061, China.
⁷ Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China. Electronic address: songlingqin@mail.xjtu.edu.cn.

PMID: 40561923
DOI: 10.1016/j.jenvman.2025.126216

Abstract

Lung cancer is a leading cause of cancer-related mortality worldwide. Particulate matter ≤2.5 μm (PM_2.5) air pollution, including ambient PM_2.5 and household PM_2.5, is a significant risk factor for this disease. However, an updated and comprehensive assessment of lung cancer burden attributable to PM_2.5 remains limited. We evaluated the deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of lung cancer attributable to total, ambient, and household PM_2.5 at the global, regional, and national levels, using the Global Burden of Disease (GBD) 1990-2021 data. The estimated annual percentage change (EAPC) was used to analyze the trends in the ASMR and ASDR. Age, sex, and the socio-demographic index (SDI) were considered. In 2021, PM_2.5 exposure accounted for approximately 0.37 million deaths and 8.9 million DALYs of lung cancer. East Asia had the highest lung cancer burden attributable to total PM_2.5. From 1990 to 2021, the global lung cancer burden attributable to both total PM_2.5 and household PM_2.5 decreased, whereas that attributable to ambient PM_2.5 increased. Furthermore, the ASDR/ASMR attributable to ambient PM_2.5 were positively related to the SDI, whereas those attributable to household PM_2.5 were negatively related. Global lung cancer deaths and DALYs attributable to ambient PM_2.5 are expected to rise continuously up to 2045. In summary, this study emphasizes the need for strengthened, region-tailored air quality policies to reduce the lung cancer burden attributable to PM_2.5 and to narrow regional inequalities.

Keywords: Fine particulate matter; GBD; Health inequity; Lung cancer; Policy implication; Spatiotemporal trend.