China could see the number of lung cancer deaths rise to around 760,000 by 2030, as the country’s rapidly aging population may offset progress made in tobacco control and air pollution reduction, according to a study published in Cancer Biology & Medicine.
China carries a major share of the global lung cancer burden. The country accounted for nearly 40% of lung cancer deaths worldwide in 2022, despite having only 18% of the world’s population.
Risk factors also remain high. In 2018, around 26.6% of Chinese adults smoked, while 68.1% of nonsmokers were exposed to secondhand smoke in public places.
Researchers from the National Cancer Center of China, the Chinese Academy of Medical Sciences and Peking Union Medical College analyzed data from 605 surveillance sites between 2013 and 2021.
The research team, led by Xin Liang and Xiaoqiu Dai, found that the crude lung cancer mortality rate increased by 2.3% annually during the study period. However, the age-standardized mortality rate remained generally stable and began declining by 2.9% annually after 2015.
The researchers said the findings show a clear difference between progress in controlling risk factors and the impact of China’s rapidly aging population.
They said the declining age-standardized mortality rate suggests that tobacco control, air pollution reduction and screening programs are having a positive effect. However, the total number of deaths continues to rise because the population is aging rapidly.
The analysis found that population aging contributed between 32% and 43% to the increase in lung cancer deaths, while population growth accounted for between 8% and 31%. Meanwhile, changes in risk factors helped reduce deaths by between 3% and 29%.
By 2030, lung cancer deaths in China are expected to reach around 760,200, an increase of 16.6% from 2022.
The study also found significant regional differences. Urban areas recorded the largest decline in the age-standardized mortality rate, which fell by 2.9% annually. The average age at death from lung cancer increased across all regions, with rural areas recording the fastest increase.
To address the growing burden of lung cancer, researchers recommended expanding low-dose spiral computed tomography (CT) screening to rural health care facilities.
They also suggested using mobile screening units and artificial intelligence-assisted tools to help interpret scans and reduce false-positive results.
The researchers said the main challenge is ensuring that prevention and treatment systems keep pace with China’s changing demographics, particularly in rural and western areas, where progress has been slower.
The study concluded that without stronger tobacco control and targeted prevention systems for older adults, the gains achieved through reducing risk factors may continue to be outweighed by the impact of population aging.
