Global, Regional, and National Burden of Lung Cancer and Associated Risk Factors, 1990–2023, with Forecasts to 2050: A Systematic Analysis for the Global Burden of Disease Study 2023

Background:&nbsp;Lung cancer is the leading cause of cancer mortality worldwide. Although age-standardised incidence and mortality rates have declined in many high-income countries due to tobacco control and advances in care, the global burden remains high.&nbsp; <div> <br> </div> <div> Methods:&nbsp;We used results from the Global Burden of Disease Study (GBD) 2023 to estimate lung cancer incidence, mortality, and disability-adjusted life-years (DALYs) across 204 countries and territories from 1990 to 2023, with forecasts through 2050. Results are reported as counts and age-standardised rates globally and by sex, World Bank income group, and GBD region. We quantified risk-attributable burden using the GBD comparative risk assessment framework and generated a decomposition analysis of changes in DALYs due to demographic and epidemiological drivers. <div> <br> </div> <div> Findings:&nbsp;In 2023, lung cancer caused an estimated 2.32 million (95% uncertainty interval 2.07–2.52) incident cases and 2.03 million (1.86–2.21) deaths worldwide, accounting for 46.6 million (42.5–50.9) DALYs. Despite increases in incident cases and deaths globally since 1990, age-standardised incidence declined to 25.2 per 100 000 (22.4–27.4), and age-standardised mortality declined to 22.2 per 100 000 (20.2–24.1). Modifiable risk factors accounted for 77.0% (73.4–80.6) of global DALYs, with tobacco, air pollution, and occupational exposures as the leading risk factors. From 1990 to 2023, age-standardised DALY rates attributable to tobacco and air pollution declined globally, but progress was uneven, with greater declines in high-income regions than in many LMICs. Forecasts indicate that annual global lung cancer deaths will increase to 3.39 million (2.66–4.30) by 2050, while age-standardised mortality rates are forecasted to change by -15.2% (-28.9 to 1.1) between 2024 and 2050.&nbsp; </div> <div> <br> </div> <div> Interpretation:&nbsp;Most of the global lung cancer burden remains potentially preventable. Continued declines in age-standardised incidence and mortality rates will be insufficient to offset demographic pressures without intensified action. Strengthening tobacco control, reducing air pollution and occupational exposures, and expanding access to timely diagnosis and treatment pathways, especially in low and middle-income countries, will be essential. </div> </div>