Global, regional, and national burden of tracheal, bronchus, and lung cancer attributable to ambient particulate matter pollution among adults aged 70 and above in 1990–2021 and projected to 2044

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Background: Tracheal, bronchus, and lung (TBL) cancer attributable to ambient particulate matter pollution (APMP) is a growing global health concern, particularly in individuals aged 70 and above. This study aims to evaluate past trends, identify key drivers, and project future disease burden. Methods: Data from the Global Burden of Disease Study 2021 was analyzed for TBL cancer-related disability-adjusted life years (DALYs) and mortality from 1990 to 2021, stratified by SDI regions. Statistical methods, including Joinpoint regression, age-period-cohort modeling, and decomposition analysis, were used to identify temporal trends and drivers of DALYs. Future projections were made using the Nordpred model. Results: From 1990 to 2021, global DALYs of TBL cancer due to APMP increased steadily (AAPC 0.75%). Population growth was the main driver, accounting for 79.37% of the increase, with epidemiological factors playing a varying role across regions. The highest DALY growth was observed in middle SDI regions (AAPC 2.99%), while high SDI regions saw a decline (AAPC -1.76%). Projections up to 2044 suggest a substantial increase in DALYs across all SDI regions, with the fastest growth expected among individuals aged 70-74, but DALY rates are projected to decline steadily. Conclusion: Population growth is the primary factor driving the increase in DALYs associated with TBL cancer, with significant regional disparities. Projections suggest a continued rise in disease burden, particularly in lower SDI regions, underlining the urgency for targeted public health interventions and strategies to mitigate exposure and improve healthcare outcomes for at-risk populations.