Trend and projection of larynx cancer incidence and mortality in China from 1990 to 2044: A Bayesian age-period-cohort modeling study

Our plain-English summary of Trend and projection of larynx cancer incidence and mortality in China from 1990 to 2044: A Bayesian age-period-cohort modeling study, by E. Ye, J. Huang, J. Wang, et al (Cancer Medicine, 2023).

The study

• Authors: E. Ye, J. Huang, J. Wang, Y. Zhao, D. Niu, J. Liu, X. Huang, S. Yue, X. Hou, J. Wu
• Journal: Cancer Medicine
• Published: 2023;12(15):16517-16530
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Larynx cancer is one of the most common cancers in head and neck, and imposes heavy burden on individual and societies. A comprehensive understanding of the burden of larynx cancer is necessary to improve prevention and control strategies. However, the secular trend of larynx cancer incidence and mortality in China remains unclear.

Methods: The incidence and deaths rates of larynx cancer from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 database. The temporal trend of larynx cancer was analyzed using a joinpoint regression model. The age-period-cohort model was used to explore the age, period, and cohort effects on larynx cancer and predict future trends up to 2044.

Results: From 1990 to 2019, the age-standardized incidence rate of larynx cancer in China increased by 1.3% (95% CI 1.1 to 1.5) in males, but decreased by 0.5% (95% CI -0.1 to 0) in females. The age-standardized mortality rate of larynx cancer in China decreased by 0.9% (95% CI -1.1 to -0.6) and 2.2% (95% CI -2.8 to -1.7) in males and females, respectively. Among the four risk factors, smoking and alcohol use contributed to a heavier burden compared to occupational exposure to asbestos and sulfuric acid with respect to mortality. Age effects showed that the incidence and deaths of larynx cancer were concentrated in people older than 50 years old. Period effects exerted the most significant effect on larynx cancer incidence for males. In terms of cohort effects, people born in the earlier cohorts presented a higher risk of larynx cancer compared with the later cohorts. From 2020 to 2044, the age-standardized incidence rates of larynx cancer continued to increase in males, whereas the age-standardized mortality rates continued to decrease in both males and females.

Conclusion: The burden of larynx cancer in China has a significant gender difference. The age-standardized incidence rates will continue to increase in males up to 2044. The disease pattern and risk factors of larynx cancer should be comprehensively studied to promote the development of timely intervention measures and relieve the burden effectively.

© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

In plain English

The study analyzed Global Burden of Disease 2019 estimates of larynx cancer in China, 1990 to 2019. Methods included joinpoint regression, age-period-cohort analysis and Bayesian projection. Male age-standardized incidence rose by an average of 1.3% per year (95% CI 1.1 to 1.5). For females, the article printed a 0.5% average annual decrease with a 95% CI of minus 0.1 to 0, which excludes that estimate. The article elsewhere called it stable. Age-standardized mortality fell by an average of 0.9% per year in males (95% CI minus 1.1 to minus 0.6) and 2.2% in females (95% CI minus 2.8 to minus 1.7). Risk factors examined were smoking, alcohol, and occupational asbestos and sulfuric acid exposure. In 2019, asbestos accounted for 1.43% of male mortality burden (smoking 85.01%) and 1.18% of female deaths. Age-standardized mortality attributed to occupational asbestos exposure declined in both sexes. Risk was higher in older ages and earlier birth cohorts. Male age-standardized incidence was projected to rise from 4.02 per 100,000 in 2019 to 5.27 in 2044. The authors noted the estimates may not match actual data. No asbestos fiber types were named.

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 2019 estimates. Methods were joinpoint regression (annual and average annual percent change), age-period-cohort analysis using the intrinsic estimator method, and a Bayesian age-period-cohort projection to 2044.
• Who was studied: Population of China, 1990 to 2019, as estimated in the Global Burden of Disease Study 2019. The age-period-cohort analysis covered ages 20 to 94 years.
• Exposure: Four risk factors as estimated in the Global Burden of Disease data: smoking, alcohol use, occupational exposure to asbestos, and occupational exposure to sulfuric acid. No fiber types, jobs or doses are given.
• Main results:
  • From 1990 to 2019, the age-standardized incidence rate of larynx cancer increased by an average of 1.3% per year (95% CI: 1.1 to 1.5) in males.
  • In females, the age-standardized incidence rate was printed as decreasing by 0.5% (95% CI as printed: -0.1 to 0). This interval does not contain the estimate.
  • The descriptive analysis described female age-standardized incidence as stable over 1990 to 2019.
  • The age-standardized mortality rate decreased by an average of 0.9% per year (95% CI: -1.1 to -0.6) in males.
  • The age-standardized mortality rate decreased by an average of 2.2% per year (95% CI: -2.8 to -1.7) in females.
  • In males in 2019, 85.01% of the larynx cancer mortality burden was attributed to smoking.
  • In males in 2019, 1.43% of the larynx cancer mortality burden was attributed to asbestos and 3.16% to sulfuric acid.
  • In females in 2019, 1.18% of larynx cancer deaths were attributed to asbestos.
  • From 1990 to 2019, the average annual percent change of the age-standardized mortality rate attributable to occupational asbestos exposure was -1.0% (95% CI: -1.3 to -0.8) in males.
  • The average annual percent change of the age-standardized mortality rate attributable to occupational asbestos exposure was -2.1% (95% CI: -2.4 to -1.8) in females.
  • The risk of larynx cancer incidence and death rose significantly from middle age and peaked over age 70.
  • Time period had a statistically significant effect only on incidence in males.
  • Later birth cohorts had a lower risk of larynx cancer incidence and mortality than earlier cohorts.
  • The male age-standardized incidence rate was projected to increase from 4.02 per 100,000 in 2019 to 5.27 per 100,000 in 2044.
  • The female age-standardized incidence rate was projected to increase from 0.63 to 0.71 per 100,000 between 2019 and 2044.
  • Projected age-standardized mortality fell from 1.82 per 100,000 in 2019 to 1.15 per 100,000 in 2044 for males.
• The authors' conclusion: The authors concluded that larynx cancer incidence in Chinese males rose over the past three decades and will keep rising for 25 years, while mortality will keep declining to 2044. They called for more study of risk factors and for interventions.
• Limitations the authors state:
  • Global Burden of Disease estimates may be inconsistent with actual data, because of a lack of survey data and heterogeneity among studies.
  • Cancer registry data may not cover all larynx cancer cases in China.
  • No subgroup analysis by clinical features or histological type was possible.
  • No stratification by province, economic development or ethnicity was possible.
  • The intrinsic estimator method cannot explain the practical significance of its parameter estimates.

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, Incidence, Occupational Exposure.

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