Despite projected declines in age-standardised rates of tracheal, bronchus, and lung cancer among older Asian adults, population ageing will sustain substantial absolute burden through 2050, underscoring the need for targeted prevention and age-responsive health-system planning.
Incident cases of TBL cancer among Asian adults aged 60 or older more than tripled from 1990 to 2023.
TBL cancer burden increased sharply with age and remained consistently higher in males throughout the study period.
Socioeconomic inequality in TBL cancer burden attenuated over the study period, particularly for mortality and DALYs.
Negative age-specific-rate components partly offset demographic effects in several Central Asian countries.
Bayesian age-period-cohort modelling projected substantial declines in age-standardised incidence and death rates from 2024 to 2050, but only modest reductions in absolute case numbers.
GBD 2023 data were used to assess incidence, prevalence, mortality, and DALYs among Asian adults aged 60 years or older from 1990 to 2023.
This research suggests that lung and airway cancers (collectively called tracheal, bronchus, and lung or TBL cancer) among older adults in Asia have grown dramatically over the past three decades, with the number of new cases more than tripling from about 335,000 in 1990 to over 1.1 million by 2023. However, much of this increase is driven by the fact that Asia's population has grown and aged significantly — when researchers account for these demographic changes by looking at rates per person, the increases appear much smaller and in some areas rates have actually declined. Men and the oldest age groups continue to carry a disproportionate share of the burden. Looking forward to 2050, the study projects that age-adjusted rates of new cases and deaths will fall substantially — by around 44–46% — likely reflecting improvements in smoking rates and medical care. Despite this encouraging trend in rates, the sheer growth and ageing of Asia's population means the total number of people affected will remain very high. In some Central Asian countries, falling disease rates have helped offset the impact of population growth, showing that prevention efforts can make a difference even amid demographic pressures. This research suggests that Asia cannot rely solely on improving medical treatments or reducing smoking to manage the lung cancer burden among older adults. Health systems will need to plan specifically for the needs of an ageing population, including expanding early detection programs and ensuring that cancer care services can handle large and growing numbers of elderly patients. The narrowing of inequality between richer and poorer countries in Asia is an encouraging sign, but substantial differences remain, pointing to the continued need for targeted resources in lower-income settings.
Zhu L, Fan L, Wen J, Peng S, Luo X, Zhang X. (2026). The shifting burden of tracheal, bronchus and lung cancer in ageing Asia: structural drivers and projections to 2050.. Annals of medicine. https://doi.org/10.1080/07853890.2026.2722478