Abstract 803: Disparities unveiled: A comprehensive analysis of evolving trends in lung cancer risk factors in the ten most populous countries

Abstract Introduction: Evolving Lung cancer (LC) trends necessitate a continual reassessment of associated risk factors. Methods: We utilized the Global Burden of Disease database to extract Age-Standardized Mortality Rates (ASMR) and risk factor-associated ASMR for Tracheal, Bronchial, and Lung cancer (TBLC) from 1990-2019. The aim was to analyze overall trends along with two pivotal LC risk factors associated trends—tobacco use and air pollution—across ten most populous nations as of 2023 population census. Joinpoint analysis was employed to analyze trends. Results: Globally, TBLC mortality has decreased by 8%, with reductions observed in both tobacco and air pollution-associated mortality. Despite a decrease in male mortality (-17%) and increase in female mortality (+15%), males have exhibited higher mortality for past three decades with M: F ratio of 2. 5 in 2019. Similarly, male mortality was higher across all countries. Globally, although tobacco and air pollution-associated mortality has decreased for males and increased for females, both risk factors are linked to significantly higher mortality in males, with M: F ratios of 4. 4 and 2. 6 for tobacco and air pollution, respectively, in 2019. For tobacco-associated ASMR, China and Indonesia have shown an increase, while China, India, Pakistan, and Nigeria have shown an increase for Air pollution-associated ASMR. On evaluating proportional ASMR, tobacco and air pollution have overall shown a reduction, indicating an increase in other or non-risk factor-related mortality. Conclusion: The fluctuating trends in tobacco-associated and the concerning rise in air pollution-associated in specific countries underscore the complex interplay of societal and environmental factors in LC mortality. The decline in ASMR associated with established risk factors emphasizes the necessity for focused interventions to tackle the changing molecular characteristics of lung cancer and its associated risk factors. Comparison of risk factor-associated Lung Cancer ASMR (1990 vs 2019) Country (ASMR per 100, 000 population) 1990 overall ASMR (N) 1990 Tobacco associated ASMR N (%) 1990 Air Pollution Associated N (%) 2019 overall ASMR (N) 2019 Tobacco associated ASMR N (%) 2019 Air Pollution Associated ASMR N (%) Global 27. 3 19. 8 (72) 5. 6 (20) 25. 2 16. 7 (66) 4. 8 (19) India 7. 0 4. 2 (60) 2. 5 (35) 8. 1 4. 0 (50) 2. 6 (33) China 31. 2 20. 2 (65) 10. 3 (33) 38. 7 26. 3 (68) 10. 7 (28) US 49. 4 40 (81) 4. 5 (9) 36. 1 26. 1 (72) 1. 5 (4) Indonesia 18. 0 10. 6 (59) 5. 4 (30) 24. 4 14. 7 (60) 4. 6 (19) Pakistan 14. 7 10. 9 (74) 5. 4 (36) 17. 2 10. 7 (63) 5. 5 (32) Nigeria 6. 8 2 (29) 2. 6 (38) 8. 3 1. 9 (23) 2. 7 (32) Brazil 18. 0 13. 9 (77) 3. 2 (18) 15. 8 9. 7 (61) 1. 5 (10) Bangladesh 9. 7 6. 9 (71) 3. 6 (37) 7. 8 4. 7 (59) 2. 6 (33) Russia 32. 4 23. 2 (72) 4. 4 (13) 22. 8 16. 6 (73) 1. 8 (8) Mexico 15. 1 9. 6 (63) 3. 4 (22) 9. 7 4. 4 (45) 1. 5 (16) Citation Format: Chinmay T. Jani, Samuel A. Kareff, Harpreet Singh, Ana Salazar Zetina, Gilberto Lopes. Disparities unveiled: A comprehensive analysis of evolving trends in lung cancer risk factors in the ten most populous countries abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 803.