Effect of Particulate Matter Pollution on Global Lung Cancer Burden: A Systematic Analysis for the Global Burden of Disease Study 1990-2021.

BACKGROUND: Lung cancer remains a leading cause of cancer mortality globally, with particulate matter pollution (PMP) identified as a critical environmental risk. This study analyzes long-term trends in age-standardized mortality (ASMR) and disability-adjusted life-year rates (ASDR) for PMP-attributable lung cancer, with projections to 2030. METHOD: Using Global Burden of Disease data, we evaluated temporal trends across age, sex, and Sociodemographic Index (SDI) regions through age-period-cohort and Bayesian models. RESULT: Global Trends: PMP-related ASMR/ASDR declined significantly over the study period, while ambient PMP (APMP)-attributable rates increased, contrasting with household air pollution (HAP)-related declines. Age and Sex Disparities: Mortality burden shifted toward older populations, with APMP-related deaths rising sharply in the elderly. Males exhibited faster declines in PMP/HAP-related mortality, whereas females faced steeper increases in APMP-attributable risks. SDI variations: High-middle SDI regions consistently had the highest PMP-related mortality, with ASMR trends reflecting industrialization phases. Projections: PMP-related burdens are expected to rise globally, driven by aging populations and persistent pollution in middle-SDI regions. CONCLUSION: The escalating burden in vulnerable populations demands urgent interventions, including air quality improvement, tobacco control, and enhanced screening, Notably, China consistently exhibited the world's highest PMP-attributable lung cancer ASMR (13.6 per 100 000 in 1990, declining to 10.1 per 100 000 in 2021). Future strategies must integrate gender-specific risk mitigation and environmental-genetic assessments to address disparities.