Ye Tian, Weihao Zhang, Yao Lu, Bruce F O'Hara, Jingjing Hu, Hanqi Feng, Jing Di, Lei Zhang, Xueying Yang
Background Early-onset tracheal, bronchial, and lung (EOTBL) cancer represents a distinct clinical entity. This study aimed to assess the global burden and temporal trends of EOTBL cancer, focusing on socioeconomic disparities, to inform global cancer control strategies. Methods Using GLOBOCAN 2022 and GBD 2023 data, we analyzed EOTBL cancer incidence, mortality, and attributable risk factors across distinct geographic regions and Human Development Index (HDI) tiers. Findings In 2022, EOTBL cancer caused 137,705 incident cases and 72,646 deaths globally. Eastern Asia showed the highest incidence. Socioeconomically, regions with a High HDI presented the highest incidence burden. However, the Medium- and Low-HDI regions experienced disproportionately high mortality burden. The temporal trends in EOTBL cancer exhibited profound national heterogeneity, closely tied to geography, human development, and sex. Risk profiles varied drastically: active smoking remained the primary driver in countries like Russia, whereas ambient particulate matter pollution emerged as a major determinant in rapidly developing economies like China. Interpretation EOTBL cancer pattern exhibits notable disparities across sex, geographic regions, and HDI levels. Framing effective global policies requires moving beyond generalized interventions toward tailored, region-specific public health strategies.