Lagged associations between climate-related indicators and cancer incidence: a global spatiotemporal analysis

The health effects of climate change are increasingly recognized, but its role in cancer remains insufficiently explored. We aimed to conduct a systematic spatiotemporal analysis to investigate the association between climatic indicators and cancer incidence of all neoplasms as well as major cancer subtypes. We assessed associations between 17 climatic indicators and incidence of all neoplasms and 34 specific cancer subtypes across 204 countries and territories from 1990 to 2021. Region-level data were analyzed using cross-correlation functions (CCF) and Granger causality analysis (GCA) to identify potential directional and lagged associations, with uncertainty addressed through meta-analytic pooling, multiple-testing correction, evaluation across multiple lag structures, and sex-stratified analyses. Global Moran’s I index with Monte Carlo permutation testing was applied to evaluate spatial clustering of significant GCA results. Our analyses revealed complex and dynamic global trends of climatic indicators and cancer incidence rates, with pronounced spatial variability. The CCF and GCA analyses demonstrated mild-to-moderate lagged associations between climatic indicators and cancer incidence, with an average predominant lag of four to five years. Among 595 climate-cancer pairs, GCA identified 105 significant associations, with air pollution (nitrogen dioxide [NO 2 ], fine particulate matter [PM2.5], and ambient ozone pollution) emerging as the category most frequently associated with cancer incidence, while additional associations were found for vapor pressure deficit (VPD), wind speed, and other indicators. Moreover, sex-specific differences and spatial clustering of significant regions were observed. This study provided a panoramic overview of climate–cancer linkages across all neoplasms and 34 cancer subtypes, offering valuable insights into the delayed associations between climate-related indicators and cancer incidence and highlighting the need for sustained attention and climate-informed policy action.