Burden of laryngeal cancer attributable to occupational asbestos exposure in China: A comprehensive analysis from 1990 to 2021

Our plain-English summary of Burden of laryngeal cancer attributable to occupational asbestos exposure in China: A comprehensive analysis from 1990 to 2021, by B. Chen, Z. Zhan, S. Yu, et al (PloS One, 2025).

The study

• Authors: B. Chen, Z. Zhan, S. Yu, J. Huang, C. Chen, J. Wang, J. Pan, S. Lin, Y. Xu
• Journal: PloS One
• Published: 2025;20(8):e0330878
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Laryngeal cancer attributable to occupational asbestos exposure remains a significant public health concern, particularly in industrialized regions. This study analyzes the burden, trends, and contributing factors of laryngeal cancer due to asbestos exposure in China from 1990 to 2021.

Methods: Data were obtained from the Global Burden of Disease Study (1990-2021). We analyzed age-standardized death rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Temporal trends were assessed using joinpoint and decomposition analyses, and an age-period-cohort (APC) model was applied to examine mortality and DALY trends across different cohorts.

Results: In 2021, there were 234 deaths and 4,430 DALYs due to laryngeal cancer attributable to occupational asbestos exposure, predominantly affecting males. Mortality rates declined from 1990 to 2008, followed by a rise until 2012, and a subsequent decline. YLDs showed a consistent increase over time. APC analysis revealed higher mortality and DALY rates in older age groups and earlier birth cohorts. Decomposition analysis indicated that epidemiological changes were the largest driver of increased deaths in men, followed by population growth and aging. For DALYs, aging and population growth were key drivers, while epidemiological changes mitigated the burden.

Conclusions: The burden of laryngeal cancer attributable to asbestos exposure has declined overall, but disability rates continue to rise, particularly among males. Effective strategies targeting prevention, early detection, and management of asbestos exposure are needed to reduce the disease burden in China.

Copyright: © 2025 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

In plain English

This study used Global Burden of Disease (GBD) 2021 model estimates of laryngeal cancer attributed to occupational asbestos exposure in China from 1990 to 2021. They are not counts of patients and are not broken down by fiber type. For 2021 they were 234 deaths (95% uncertainty interval 123 to 379), 195 (90 to 334) in males and 39 (12 to 74) in females, and 4,430 disability-adjusted life years (2,267 to 7,341), which combine years lost to early death and years lived with disability. China's age-standardized death rate fell from 0.02 per 100,000 (0.01 to 0.03) in 1990 to 0.01 (0.01 to 0.02) in 2021; the global rate fell from 0.08 (0.04 to 0.11) to 0.04 (0.02 to 0.06). The overall burden in China declined until 2008, rose to a peak in 2012, then declined. China's rate of years lived with disability rose; the global rate fell. Among men, changes in disease risk ("epidemiological changes") contributed most to the increase in deaths. The authors concluded that older men with historical occupational exposure bear a disproportionate burden.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive secondary analysis of modeled Global Burden of Disease 2021 estimates, using joinpoint regression, age-period-cohort analysis and decomposition analysis
• Who was studied: Population of China, 1990 to 2021, as represented in GBD 2021 estimates of laryngeal cancer attributable to occupational asbestos exposure, broken down by sex and 5-year age groups; global estimates were used for comparison
• Exposure: Occupational asbestos exposure, estimated at population level through the GBD asbestos impact ratio, which is based on excess mesothelioma deaths compared with a highly exposed reference population. The burden estimates are not broken down by fiber type. Chrysotile is mentioned only in the Discussion, where the authors cite other research on its biological effects.
• Main results:
  • In 2021, an estimated 234 deaths (95% uncertainty interval 123 to 379) in China were attributed to laryngeal cancer from occupational asbestos exposure: 195 (90 to 334) in males and 39 (12 to 74) in females
  • In 2021, there were an estimated 4,430 DALYs (95% uncertainty interval 2,267 to 7,341) in China: 3,725 in males and 705 in females
  • The age-standardized death rate in China fell from 0.02 per 100,000 (0.01 to 0.03) in 1990 to 0.01 (0.01 to 0.02) in 2021. The global rate fell from 0.08 (0.04 to 0.11) to 0.04 (0.02 to 0.06).
  • In China, the overall burden declined from 1990 to 2008, rose to a peak in 2012, and then gradually declined
  • China's age-standardized DALY rate fell from 0.3 to 0.21 per 100,000 (global: 1.58 to 0.78). China's YLD rate was 0.01 in both 1990 and 2021, but the table gives a positive change of 0.68 (95% uncertainty interval 0.41 to 0.94). Over the same period the global YLD rate fell, with a change of −1.43.
  • In the age-period-cohort analysis, death rates rose with age, and earlier birth cohorts had higher death rates than more recent cohorts
  • Decomposition analysis, deaths: among men, epidemiological changes contributed most to the increase in deaths, followed by population growth and aging
  • Decomposition analysis, DALYs: epidemiological changes reduced the burden, while aging and population growth increased it
• The authors' conclusion: The authors concluded that laryngeal cancer attributable to occupational asbestos exposure remains a persistent public health challenge in China. They said that older men with historical occupational exposure bear a disproportionate burden and need targeted interventions.
• Limitations the authors state:
  • The analysis relies on modeled GBD 2021 estimates, whose accuracy depends on the quality and availability of input data
  • Underdiagnosis and limited access to healthcare in rural areas may lead to underreporting of laryngeal cancer
  • Other risk factors, such as smoking, alcohol use and environmental pollutants, were not assessed
  • The study is descriptive and does not assess the effectiveness of specific interventions

Topics

The National Library of Medicine indexes this study under subjects our site covers: Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Asbestos Exposure.

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