National and subnational trends in incidence and mortality of lung cancer in Iran from 1990 to 2016

AIM: Lung cancer is the most common cancer in incidence and mortality worldwide. The aim of the current study was to present population-based estimates of lung cancer epidemiology by gender and age group at national and subnational levels during the 27-year period of 1990-2016. METHODS: This study was part of the NASBOD project (National and Subnational Burden of Disease, Injuries, and Risk Factors). Cancer incidence and mortality statistics were obtained from the Iran Cancer Registry database and the national Death Registration System. The two-stage mixed effects and spatiotemporal model were fitted to all-cancer incidence and mortality data. Thereafter, the cancer-specific incidence and mortality fraction for each age group, gender, province, and year were applied to the data to estimate the lung cancer incidence and mortality. RESULTS: The age-standardized incidence rate showed a sevenfold increase during 27 years of the study. Lung cancer deaths showed an upward trend from 1990 to 2001 and subsequently decreased during the latter half of the study period. At provincial level, there was a wide range between the lowest and highest, from 3.2 to 13.2 in incidence rate and from 5.2 to 10.7 in mortality rate. CONCLUSION: The study showed an increasing trend in lung cancer incidence at national and subnational levels from 1990 to 2016, while the mortality rate peaked and then declined in the 2000s. The increasing trend of lung cancer in the overall population and the provincial disparities necessitate urgent implementation of preventive strategies and cancer control policies.