Global disparities in lifetime risk of lung cancer: links to socioeconomic development, smoking, and fine particulate matter from GLOBOCAN 2022

Abstract

Background Lung cancer is the leading cause of cancer-related death worldwide, with significant regional and sex differences in incidence and mortality. Although age-standardized rates are commonly used for comparisons, they do not reflect the cumulative lifetime risk, which is important for understanding the full burden of the disease because it captures the probability of an individual developing or dying from lung cancer over their lifetime. Methods This study estimates global lifetime risk of incidence (LRI) and lifetime risk of mortality (LRM) using GLOBOCAN 2022 data and the adjusted for multiple primaries method. Socioeconomic indicators (Human Development Index, national income) came from the UN Development Programme and World Bank; air pollutant exposures from global environmental databases; and smoking-related indicators from the WHO Global Health Observatory. Associations between LRI/LRM and these factors were then explored. Results In 2022, global LRI was 4.91%, and LRM was 4.07%. Regionally, North America exhibited the highest LRI (7.30%) and LRM (5.38%), while Africa had the lowest (LRI: 0.99%, LRM: 0.93%). Globally and across all continents, lifetime risks were significantly higher in males than in females. Regression analysis revealed that smoking prevalence was positively associated with both LRI (β = 0.001, P < 0.001) and LRM (β = 0.0002, P < 0.01). Exposure to PM1 was strongly linked to higher LRI (β = 0.40, P = 0.001) and LRM (β = 0.20, P = 0.006); PM2.5 showed similar associations (LRI: β = 0.36, P = 0.002; LRM: β = 0.18, P = 0.015). The strongest associations were observed for fine particles (PM1 and PM2.5). Furthermore, higher national socioeconomic development was positively correlated with increased LRI and LRM. Conclusion These findings suggest that socioeconomic and environmental factors may be associated with regional disparities in lung cancer burden. This evidence could offer insights for targeted prevention policies, including smoking control and air quality management.