Long-Term Changes in Premature Death of Lung Cancer in a Developed Region of China: A Population-Based Study From 1973 to 2019

Abstract Background: Lung cancer is a leading cause of deaths worldwide, and its incidence shows an upward trend. The study in the long-term changes in premature death of lung cancer in a developed region of China has a great exploratiory significance to further clarify the effectiveness of intervention measures.Methods: Cancer death data were collected from the Mortality Registration System of Shanghai Pudong New Area (PNA). We analysed crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of lung cancer from 1973 to 2019. Temporal trends of CMR, ASMRW, and rate of YLL were calculated by joinpoint regression expressed as an annual percent change (APC) with corresponding 95% confidence interval.Results: 80,543,137 person-years were enrolled in this study in PNA from 1973 to 2019. There were 42,229 deaths in permanent residents from lung cancer. The CMR and ASMRW were 52.43/105 person-years and 27.79/105 person-years. YLL due to premature death from lung cancer was 481779.14 years, and the rate of YLL was 598.16/105 person-years. The CMR, and rate of YLL for deaths had significantly increasing trends in males, females, and the total population (P<0.001). The CMR in the total population increased by 2.86% (95% CI=2.66%-3.07%, P < 0.001) per year during the study period. The YLL rate increased with an APCC of 2.21% (95% CI = 1.92% to 2.51%, P < 0.001) per year. The contribution rates of increased values of CMR caused by demographic factors were more evident than non-demographic factors.Conclusion: The aging population, progress of treatment, smoking, and even environmental pollution may be the factors that affect the long-term changes in premature death of lung cancer in PNA from1973 to 2019. Our research can help us to understand the changes of lung cancer mortality, and our results could also be used for other similar cities in designing future prevention plans.