Global, regional and country-specific burden of larynx cancer due to occupational exposure to asbestos: a systematic analysis of the Global Burden of Disease Study 2021

Our plain-English summary of Global, regional and country-specific burden of larynx cancer due to occupational exposure to asbestos: a systematic analysis of the Global Burden of Disease Study 2021, by S. Zhang, D. Du, P. Li, et al (BMC Public Health, 2025).

The study

• Authors: S. Zhang, D. Du, P. Li, Y. Chen, X. Zhang
• Journal: BMC Public Health
• Published: 2025;25(1):2223
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Laryngeal cancer (LC) attributable to occupational asbestos exposure remains a significant global health concern. This study aimed to assess the global burden of LC caused by asbestos exposure using data from the Global Burden of Disease (GBD) 2021 study.

Methods: Data from the Global Burden of Diseases study 2021 were used to analyze the global burden of LC, including incidence, mortality, prevalence, and disability-adjusted life years (DALYs) from 1990 to 2021. The study employed age-standardized rates (ASR) for comparison. Trend analysis was performed using annual percentage change (EAPC) to examine temporal changes in LC burden. Bayesian age-period-cohort modeling was utilized to project future trends from 2022 to 2046.

Results: In 2021, the global burden of LC attributable to occupational asbestos exposure was 3,392 deaths and 66,909 DALYs. The burden was significantly higher in males compared to females. The age-standardized mortality rate was highest in high-SDI regions, but low- and middle-SDI regions showed increasing trends. From 1990 to 2021, global LC mortality and DALYs decreased, with a notable reduction in high-income countries, while many low- and middle-income countries experienced either stable or rising trends. Projections indicate continued decline in high-income countries but persistent or increasing burden in lower-income regions.

Conclusion: This study highlights the ongoing global disparities in the burden of LC due to occupational asbestos exposure. While high-income countries have made significant progress in reducing this burden, low- and middle-income countries continue to face challenges due to ongoing asbestos use.

© 2025. The Author(s).

In plain English

This study analysed existing Global Burden of Disease (GBD) 2021 estimates, not new data. The authors took GBD estimates of larynx cancer attributable to occupational asbestos exposure for 204 countries and territories, 1990 to 2021, measured trends, and projected trends to 2046. No asbestos fiber types are named. For 2021, GBD estimated 3,392 deaths (uncertainty interval 1,892 to 5,135) and 66,909 disability-adjusted life years (DALYs, years of healthy life lost; interval 36,943 to 102,101) worldwide. Of these deaths, an estimated 3,211 (1,739 to 4,976) were in males and 181 (87 to 293) in females. The global age-standardized death rate fell from 1990 to 2021, with an estimated annual percentage change of −2.01% (interval −2.09 to −1.93). High-SDI (most developed) regions had the most deaths in 2021; rates rose in low and low-middle SDI regions. The United States, India and France had the most deaths; Georgia had the fastest-rising death rate. Projections showed continued global decline. The authors noted sparse data in low-resource settings and did not study smoking or alcohol. Several printed numbers contradict the article's own tables.

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: Secondary analysis of Global Burden of Disease 2021 estimates, with trend analysis (estimated annual percentage change) and Bayesian age-period-cohort projections to 2046
• Who was studied: GBD-modelled populations of 204 countries and territories, grouped into 5 SDI regions and 21 GBD regions, 1990 to 2021, analysed by sex and age group
• Exposure: Occupational exposure to asbestos as defined in the GBD risk-factor estimates; no fiber types, products, jobs or doses specified
• Main results:
  • Globally in 2021, an estimated 3,392 deaths (95% UI 1,892 to 5,135) and 66,909 DALYs (95% UI 36,943 to 102,101) from larynx cancer were attributable to occupational asbestos exposure
  • In 2021, males had an estimated 3,211 deaths (95% UI 1,739 to 4,976) and 63,628 DALYs (95% UI 34,134 to 98,988). Females had 181 deaths (95% UI 87 to 293) and 3,281 DALYs
  • From 1990 to 2021 the global age-standardized mortality rate declined, with an estimated annual percentage change (EAPC) of −2.01 (95% UI −2.09 to −1.93), that is, about −2.01% per year
  • The global age-standardized DALY rate also declined from 1990 to 2021, with an EAPC of −2.32 (95% UI −2.39 to −2.24)
  • In 2021, high-SDI regions had the most deaths, 1,512 (95% UI 880 to 2,192), and the highest age-standardized mortality rate, 0.06 per 100,000 (95% UI 0.04 to 0.09)
  • Mortality rates trended upward in low and low-middle SDI regions from 1990 to 2021. Table 1 gives an EAPC of 0.62 (0.53 to 0.72) for low-middle SDI and 0.31 (0.14 to 0.48) for low SDI
  • By country in 2021, the United States had the most deaths, 381 (95% UI 217 to 551), followed by India with 355 (95% UI 177 to 612) and France with 267
  • The largest rise in mortality rate from 1990 to 2021 was in Georgia, with an EAPC of 10.79 (95% CI 5.7 to 22.40)
  • The model projected that global mortality and DALY burden would continue to decline through 2046
• The authors' conclusion: The authors concluded that there are ongoing global disparities in this burden. In their view, high-income countries have reduced it, while low- and middle-income countries continue to face challenges due to ongoing asbestos use.
• Limitations the authors state:
  • Estimates rely on high-quality registry data, which are sparse in low-resource settings
  • The quality of the analysis depends on the availability and accuracy of national data, which may be incomplete in underrepresented regions
  • Only asbestos was studied; smoking and alcohol may interact with asbestos and were not analysed
  • The study did not directly evaluate whether asbestos policies were effective

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, Occupational Exposure, Asbestos Exposure.

Related studies

• Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016 — GBD 2016 Occupational Risk Factors Collaborators (2020)
• Global, regional, and national burden of ovarian cancer, 1990-2021, and projections to 2050: a cross-sectional analysis of the Global Burden of Disease Study 2021 — W. Xie, S. Tang, et al. (2026)
• Deaths burden of laryngeal cancer attributable to occupational exposure in the male working age population: findings from global burden of disease study 2021 — D. Wang, S. Yang, et al. (2025)
• Global, regional, and national burden of ovarian cancer among young women during 1990-2019 — Q. Zhuang, G. Gu, et al. (2025)
• Global, regional and national mortality burden of laryngeal cancer attributable to occupational exposure to sulfuric acid and asbestos: 1990-2021 and projections to 2040 — X. Gong, Y. Xu, et al. (2025)
• Health inequality and the global burden of mesothelioma: insights from the global burden of disease study 2021 — L. Lv, W. Gao, et al. (2025)

Browse more research in BMC Public Health, or return to medical research.