Population aging is driving an increase in lung cancer mortality in China despite improved prevention and treatment efforts.
RT’s Three Key Takeaways:
- Aging Demographic Impact: Population aging in China is projected to drive lung cancer deaths to 760,200 by 2030, representing a 16.6% increase from 2022 levels despite gains in risk-factor control.
- Mortality Rate Paradox: While crude mortality rates rose 2.3% annually from 2013 to 2021, the age-standardized mortality rate fell by 2.9% per year after 2015, suggesting that demographic shifts are masking the success of prevention programs.
- Screening Expansion Needs: Researchers advocate for expanding low-dose spiral computed tomography (CT) screening to rural healthcare facilities and utilizing artificial intelligence to improve diagnostic accuracy for an aging population.
China is expected to see lung cancer deaths reach approximately 760,000 by 2030 as an aging population offsets progress in tobacco control and air pollution reduction, according to a study published in Cancer Biology & Medicine.
The country carries a disproportionate burden of the disease, accounting for nearly 40% of global lung cancer deaths in 2022 despite making up only 18% of the world population. Risk factors remain high, with 26.6% of Chinese adults smoking in 2018 and 68.1% of non-smokers exposed to secondhand smoke in public areas.
Researchers from the National Cancer Center (China), Chinese Academy of Medical Sciences, and Peking Union Medical College analyzed data from 605 surveillance sites between 2013 and 2021. The team, led by Xin Liang and Xiaoqiu Dai, found that while the crude lung cancer mortality rate rose by 2.3% annually during the study period, the age-standardized mortality rate (ASMR) remained stable overall and declined by 2.9% per year after 2015.
“We’re seeing a real paradox,” said the authors in a news release. “On one hand, the age‑standardized mortality rate is falling—that means our tobacco control efforts, air pollution measures, and screening programs are having a genuine impact. But on the other hand, China’s population is aging so rapidly that the total number of lung cancer deaths is still going up.”
Decomposition analysis revealed that population aging contributed 32% to 43% of the increase in lung cancer deaths, and population growth added 8% to 31%. Conversely, changes in risk factors actually reduced deaths by 3% to 29%. By 2030, the projected death toll of 760,200 represents a 16.6% increase compared with 2022.
The study highlighted regional disparities, noting that urban areas saw the sharpest ASMR declines at 2.9% per year. The mean age at death from lung cancer increased across all regions, with rural areas showing the fastest rise.
To address the growing burden, the researchers suggested that low-dose spiral computed tomography (CT) screening should be expanded to rural healthcare facilities. They also recommended the use of mobile screening units and artificial intelligence-assisted interpretation to reduce false positives.
“The challenge now is to make sure our prevention and treatment systems keep pace with this demographic shift, especially in rural and western areas where the gains have been slowest,” said the researchers in a news release.
The study concluded that without intensified tobacco control and precision prevention systems tailored to older adults, the gains achieved through risk-factor control will continue to be eclipsed by demographic forces.
