Global burden and trend of tracheal, bronchus, and lung cancer attributable to residential radon in Southeast Asia, East Asia and Oceania: A global benchmarking analysis.

Abstract

e22518 Background: The burden of tracheal, bronchus and lung cancer (TBLc) attributable to residential radon (RR) in Southeast Asia (SEA), East Asia (EA), and Oceania is under investigation due to significant regional variations in geological and residential environments, which influence radon exposure levels. Given the elevated risks associated with volcanic activity in SEA, granitic regions in East Asia, and uranium-rich soils in Oceania, this study aims to understand the burden of TBLc attributable to RR in SEA, EA, and Oceania. Methods: Using, standardized global burden of disease study 2021, we estimated death and disability adjusted life years (DALYs) due to TBLc attributable to RR by age, sex, year and location across the SEA, EA and Oceania from 1990-2021. Results: The total number of deaths due to TBLc attributable to RR increased from 11,512 (95% uncertainty interval: -5,615 to 30,454) in 1990 to 33,123 (-17,228 to 88,947) in 2021. Similarly, DALYs rose from 322,145 (-159,084 to 850,661) in 1990 to 781,174 (-407,077 to 2,099,185) in 2021. The highest annual percentage change (APC) in age-standardized mortality rate (ASMR) was observed in Indonesia (1.09%), followed by Niue (0.63%), Marshall Islands (0.5%), Kiribati (0.47%), China (0.36%), Vietnam (0.35%), and Malaysia (0.26%) from 1990 to 2021. Regionally, East Asia recorded the highest APC in ASMR (0.36%), followed by Southeast Asia (0.18%) and Oceania (0.14%). For age-standardized disability-adjusted life year rates (ASDALR), Oceania showed the highest APC (0.1%), followed by Southeast Asia (0.05%) and East Asia (0.04%). By age group, the APC in total death counts increased by 1.59% annually among individuals aged 20–54 years and by 1.52% among those aged 55 years and older. In terms of DALYs, the APC rose by 3.44% for individuals aged 55 years and older and by 1.47% for those aged 20–54 years. By gender, the APC in ASMR was higher in females (0.62%) compared to males (0.32%). Conversely, ASDALR showed a slight annual decline in males (-0.03%) but increased in females by 0.26% from 1990 to 2021. Conclusions: Deaths due to TBLc attributable to RR accounted for 4.36% of all TBLc attributable risk factors in 2021. Regional disparities, higher risks in older populations, and significant gender differences highlight the importance of targeted strategies, such as public education on radon exposure, implementation of mitigation measures like improved ventilation and radon testing, and prioritization of high-risk regions. Clinicians play a vital role by integrating environmental exposure assessments into routine care and advocating for early detection and management of radon-related TBLc.