Analysis of the burden and changing trends of tracheal, bronchus, and lung cancer attributable to high fasting plasma glucose in China, 1990-2021_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TAO Yancheng ^1,2,3 , HU Shoucai ^1,2,3 , YANG Chenglong ^1,2,3 , MA Haotian ^1,2,3 , JIANG Yipeng ^1,2,3 ,  LI Qingxin ^1,2

1. Department of Plateau Medicine, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730000, P. R. China;
2. Department of General Thoracic Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730000, P. R. China;
3. First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;

Corresponding?author：

LI Qingxin, Email: liqxchest@126.com

Keywords：

High fasting plasma glucose; tracheal, bronchus, and lung cancer; disease burden; change trend; Joinpoint model; China

DOI：

10.7507/1007-4848.202509039

Video：

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Objective To analyze the disease burden and its changing trends of tracheal, bronchus, and lung cancer (TBL) attributable to high fasting plasma glucose (HFPG) in China from 1990 to 2021, and to provide key strategic evidence for the prevention and treatment of TBL. Methods Data related to TBL attributable to HFPG in China from 1990 to 2021 were collected from the Global Burden of Disease Study 2021 database, including mortality rate, disability-adjusted life years (DALYs), age-standardized rates, and other indicators. The Joinpoint regression model was applied to analyze the temporal trends of these indicators. Furthermore, the grey prediction model GM (1, 1) was used to forecast the disease burden of TBL attributable to HFPG in China from 2022 to 2031. Results From 1990 to 2021, the overall disease burden of TBL attributable to HFPG in China showed an upward trend. The total number of deaths, DALYs, crude mortality rate, age-standardized mortality rate, crude DALYs rate, and age-standardized DALYs rate increased from 4700, 121300 person-years, 0.40/100000, 0.61/100000, 10.31/100000, and 14.10/100000 in 1990 to 17400, 386500 person-years, 1.22/100000, 0.82/100000, 27.16/100000, and 17.72/100000 in 2021, with growth rates of 270.21%, 218.63%, 205.00%, 34.43%, 163.43%, and 25.67%, respectively. The increase rates among females were higher than those among males. Analysis using the Joinpoint regression model indicated that both the age-standardized mortality rate and age-standardized DALYs rate exhibited a significant upward trend, with average annual percentage changes (AAPC) of 1.01% and 0.82%, respectively, during 1990-2021 (P<0.05). The disease burden across different age and gender groups generally increased from 1990 to 2021. Mortality and DALYs rates for both males and females rose with advancing age, with elderly individuals and males constituting the primary affected populations. The GM (1, 1) grey prediction model projected continued increases in mortality rate, age-standardized mortality rate, DALYs rate, and age-standardized DALYs rate of TBL attributable to HFPG in China from 2022 to 2031, reaching 1.64/100000, 1.06/100000, 36.45/100000, and 21.81/100000, respectively, by 2031. Conclusion The disease burden of TBL attributable to HFPG remains substantial in China from 1990 to 2021, with males and elderly populations bearing the highest burden. However, the growth rate of disease burden is faster among females compared to males. It is predicted that the disease burden will continue to rise over the next decade, necessitating enhanced focus on early diagnosis and treatment for women and older adults.

Citation： TAO Yancheng, HU Shoucai, YANG Chenglong, MA Haotian, JIANG Yipeng, LI Qingxin. Analysis of the burden and changing trends of tracheal, bronchus, and lung cancer attributable to high fasting plasma glucose in China, 1990-2021. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(9): 1419-1427. doi: 10.7507/1007-4848.202509039 Copy

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1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Xie J, Liu Z, Ren L, et al. Global, regional, and national time trends in cancer mortality attributable to high fasting plasma glucose: an age-period cohort analysis[J/OL]. BMC Public Health, 2023, 23(1): 1361. DOI: 10.1186/s12889-023-16076-x.
3. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants[J]. Lancet, 2011, 378(9785): 31-40.
4. Moradi-Lakeh M, Forouzanfar MH, El Bcheraoui C, et al. High fasting plasma glucose, diabetes, and its risk factors in the Eastern Mediterranean Region, 1990-2013: findings from the Global Burden of Disease Study 2013[J]. Diabetes Care, 2017, 40(1): 22-29.
5. Dai H, AlSalhe TA, Chalghaf N, et al. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990-2017: an analysis of the Global Burden of Disease Study[J/OL]. PLoS Med, 2020, 17(7): e1003198. DOI: 10.1371/journal.pmed.1003198.
6. Wu J, He H, Zhang Q, et al. Fasting blood glucose was linearly associated with colorectal cancer risk in the population without self-reported diabetes mellitus history[J/OL]. Medicine (Baltimore), 2021, 100(34): e26974. DOI: 10.1097/MD.0000000000026974.
7. Zhang N, Wang Y, Tse G, et al. Association of visit-to-visit variability in fasting plasma glucose with digestive cancer risk[J/OL]. Oxid Med Cell Longev, 2022, 2022: 4530894. DOI: 10.1155/2022/4530894.
8. Safiri S, Nejadghaderi SA, Karamzad N, et al. Global, regional and national burden of cancers attributable to high fasting plasma glucose in 204 countries and territories, 1990-2019[J/OL]. Front Endocrinol (Lausanne), 2022, 13: 879890. DOI: 10.3389/fendo.2022.879890.
9. Shi J, Xiong L, Li J, et al. A linear dose-response relationship between fasting plasma glucose and colorectal cancer risk: systematic review and meta-analysis[J/OL]. Sci Rep, 2015, 5: 17591. DOI: 10.1038/srep17591.
10. Hong SH, Noh E, Kim J, et al. Fasting plasma glucose variability and gastric cancer risk in individuals without diabetes mellitus: a nationwide population-based cohort study[J/OL]. Clin Transl Gastroenterol, 2020, 11(9): e00221. DOI: 10.14309/ctg.0000000000000221.
11. Luo J, Chen YJ, Chang LJ. Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients[J]. Lung Cancer, 2012, 76(2): 242-247.
12. 屈彥, 王天一, 楊津, 等. GBD數據庫的數據提取方法與流程[J]. 中國循證心血管醫學雜志, 2019, 11(9): 1043-1046.Qu Y, Wang TY, Yang J, et al. GBD database application and data extraction methods and processes[J]. Chin J Evidence-Based Cardiovasc Med, 2019, 11(9): 1043-1046.
13. GBD 2017 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018, 392(10159): 1923-1994.
14. GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2022, 400(10352): 563-591.
15. 胡守財, 陶堰成, 馬浩天, 等. 1990—2019年中國非風濕性瓣膜性心臟病疾病負擔及變化趨勢分析[J]. 中國循環雜志, 2024, 39(8): 806-812.Hu SC, Tao YC, Ma HT, et al. Disease burden and changing trend of non-rheumatic valvular heart disease from 1990 to 2019 in China[J]. Chin Circ J, 2024, 39(8): 806-812.
16. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates[J]. Stat Med, 2000, 19(3): 335-351.
17. Yang S, Lin S, Li N, et al. Burden, trends, and risk factors of esophageal cancer in China from 1990 to 2017: an up-to-date overview and comparison with those in Japan and South Korea[J/OL]. J Hematol Oncol, 2020, 13(1): 146. DOI: 10.1186/s13045-020-00981-4.
18. Tapper EB, Parikh ND. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study[J/OL]. BMJ, 2018, 362: k2817. DOI: 10.1136/bmj.k2817.
19. Sunkara V, Hébert JR. The application of the mortality-to-incidence ratio for the evaluation of cancer care disparities globally[J]. Cancer, 2016, 122(3): 487-488.
20. Huang JC. Application of grey system theory in telecare[J]. Comput Biol Med, 2011, 41(5): 302-306.
21. 李富, 胡守財, 龍海, 等. 1990年至2021年中國歸因于二手煙的氣管、支氣管和肺癌疾病負擔趨勢及未來預測分析[J]. 中國腫瘤臨床, 2025, 52(16): 834-842.Li F, Hu SC, Long H, et al. Trends and future predictions of the burden of tracheal, bronchus, and lung cancer attributed to secondhand smoke in China from 1990 to 2021[J]. Chin J Clin Oncol, 2025, 52(16): 834-842.
22. Rehman S, Rehman E, Ikram M, et al. Cardiovascular disease (CVD): assessment, prediction and policy implications[J/OL]. BMC Public Health, 2021, 21(1): 1299. DOI: 10.1186/s12889-021-11334-2.
23. Yang X, Zou J, Kong D, et al. The analysis of GM (1, 1) grey model to predict the incidence trend of typhoid and paratyphoid fevers in Wuhan City, China[J/OL]. Medicine (Baltimore), 2018, 97(34): e11787. DOI: 10.1097/MD.0000000000011787.
24. Liu C, Zhu S, Zhang J, et al. Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis, 1990-2019: a decomposition and age-period-cohort analysis[J]. J Gastroenterol, 2023, 58(12): 1222-1236.
25. Clegg LX, Hankey BF, Tiwari R, et al. Estimating average annual per cent change in trend analysis[J]. Stat Med, 2009, 28(29): 3670-3682.
26. Gong Y, Jiang Q, Zhai M, et al. Thyroid cancer trends in China and its comparative analysis with G20 countries: projections for 2020-2040[J/OL]. J Glob Health, 2024, 14: 04131. DOI: 10.7189/jogh.14.04131.
27. Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation[J]. Science, 2009, 324(5930): 1029-1033.
28. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation[J]. Cell, 2011, 144(5): 646-674.
29. 劉宗超, 李哲軒, 張陽, 等. 2020全球癌癥統計報告解讀[J]. 腫瘤綜合治療電子雜志, 2021, 7(2): 1-14.Liu ZC, Li ZX, Zhang Y, et al. Interpretation on the report of Global Cancer Statistics 2020[J]. J Multidiscipl Cancer Manag (Electronic Version), 2021, 7(2): 1-14.
30. Zhou J, Xi C, Luan Z, et al. Burden of tracheal, bronchus, and lung cancer attributable to high fasting plasma glucose[J]. Arch Iran Med, 2025, 28(5): 286-295.
31. 尤莉莉, 趙金紅, 陳新月, 等. 國家基本公共衛生服務項目十年評價(2009—2019年)系列報告(二)—國家基本公共衛生服務項目實施十年的進展與成效[J]. 中國全科醫學, 2022, 25(26): 3209-3220.You LL, Zhao JH, Chen XY, et al. National essential public health services programs over the past decade research report two: progress and achievements of the implementation of national essential public health services programs over the past decade[J]. Chin Gen Pract, 2022, 25(26): 3209-3220.
32. 赫捷, 李霓, 陳萬青, 等. 中國肺癌篩查與早診早治指南(2021, 北京)[J]. 中國腫瘤, 2021, 30(2): 81-111.He J, Li N, Chen WQ, et al. China guideline for the screening and early detection of lung cancer (2021, Beijing)[J]. China Cancer, 2021, 30(2): 81-111.
33. 王璐, 洪群英. 肺結節診治中國專家共識(2018年版)解讀[J]. 中國實用內科雜志, 2019, 39(5): 440-442.Wang L, Hong QY. Interpretation of Chinese expert consensus on the diagnosis and treatment of pulmonary nodules (2018 version)[J]. Chin J Pract Intern Med, 2019, 39(5): 440-442.
34. 中華醫學會糖尿病學分會. 中國2型糖尿病防治指南(2013年版)[J]. 中國糖尿病雜志, 2014, 22(8): 2-42.Chinese Diabetes Society, Chinese Medical Association. Chinese clinical guidelines for type 2 diabetes prevention and treatment (2013 edition)[J]. Chin J Diabetes, 2014, 22(8): 2-42.
35. 辛雯艷, 郭曉莉, 何小雙, 等. 1990-2019年我國居民肺癌死亡水平與疾病負擔趨勢預測研究[J]. 中華腫瘤防治雜志, 2024, 31(2): 65-73.Xin WY, Guo XL, He XS, et al. Epidemiological trends and projections of lung cancer mortality and disease burden in Chinese residents, 1990-2019[J]. Chin J Cancer Prev Treat, 2024, 31(2): 65-73.
36. Li Y, Teng D, Shi X, et al. Prevalence ofdiabetes recorded in mainland China using 2018 diagnosticcriteria from the American Diabetes Association: national crosssectional study[J/OL]. BMJ, 2020, 369: m997. DOI: 10.1136/bmj.m997.
37. Zhang M, Yang L, Wang L, et al. Trends in smoking prevalence in urban and rural China, 2007 to 2018: findings from 5 consecutive nationally representative cross-sectional surveys[J/OL]. PLoS Med, 2022, 19(8): e1004064. DOI: 10.1371/journal.pmed.1004064.
38. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
39. Stabile LP, Davis AL, Gubish CT, et al. Human non-small cell lung tumors and cells derived from normal lung express both estrogen receptor alpha and beta and show biological responses to estrogen[J]. Cancer Res, 2002, 62(7): 2141-2150.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of the burden and changing trends of tracheal, bronchus, and lung cancer attributable to high fasting plasma glucose in China, 1990-2021

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