Trends in incidence and mortality of lung cancer and age-period-cohort model analysis in Zibo, Shandong Province, 2014-2024.

BACKGROUND: Lung cancer is the leading malignancy worldwide and a major public health challenge in China. Driven by population aging, tobacco use and air pollution, its disease burden remains severe. Zibo is a densely populated industrial city with a heavy lung cancer burden. Understanding the incidence and mortality trends and quantifying age-period-cohort effects are critical for targeted prevention and control. This study analyzed data from 2014 to 2024 to identify trends and high-risk populations to inform evidence-based intervention strategies. OBJECTIVE: This study aimed to examine trends in lung cancer incidence and mortality among residents of Zibo from 2014 to 2024, evaluate the independent effects of age, period and birth cohort, identify high-risk populations and thereby provide evidence for developing targeted lung cancer prevention and intervention strategies. METHODS: Individual registration data on lung cancer incidence and mortality among registered residents in Zibo from 2014 to 2024 were obtained. The joinpoint regression was used to analyze temporal trends in incidence and mortality rates, and the average annual percentage change (AAPC) with 95% confidence interval (CI) was calculated. The age-period-cohort model was applied to quantify the effects of age, period and cohort on lung cancer incidence and mortality risk among residents aged ≥20 years. RESULTS: From 2014 to 2024, the age-standardized incidence rates of lung cancer among males, females and the overall population in Zibo all showed a significant upward trend, while the age-standardized mortality rates showed a downward trend. The AAPC for the overall standardized incidence rate was 4.34% (95% CI: 2.14-6.59, p< 0.05), and the AAPC for the overall standardized mortality rate was -2.13% (95% CI: -3.53 to -0.72, p< 0.05). The standardized incidence and mortality rates among males were consistently higher than those in females (p< 0.05 for both). The age effect on lung cancer incidence first increased and then decreased with age, the period effect increased over time, and the cohort effect decreased with successive birth cohorts. The age effect on lung cancer mortality increased with age, the period effect increased over time among male, and decreased over time among females. The cohort effect also generally decreased across successive birth cohorts. CONCLUSION: From 2014 to 2024, the incidence rate of lung cancer in Zibo continued to increase, while the mortality rate showed a downward trend. Prevention and control of lung cancer should be continuously strengthened in the elderly and males.