The disease burden of cancer attributable to smoking worldwide from 1990 to 2021 - an analysis of the global burden of disease study 2021

Sep 22, 2026

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Global cancer mortality and disability-adjusted life years (DALYs) attributable to smoking from 1990 to 2021 were quantified and trend patterns were characterized using the Global Burden of Disease (GBD) database, with forecasts for the subsequent 20 years. Analyses extracted annual mortality, DALYs, and age-standardized rates across 204 countries, applying Joinpoint regression and ARIMA modeling to estimate temporal change and project future burdens. Results show rising deaths and DALYs alongside declining age-standardized rates.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Objective

Methods

Results

Conclusion

Background

Smoking as a major risk factor

Cancer burden context and related risk factors

Wei et al. World Journal of Surgical Oncology (2026) 24:91 [https://doi.org/10.1186/s12957-026-04197-7](https://doi.org/10.1186/s12957-026-04197-7) World Journal of Surgical Oncology RESEARCH Open Access The disease burden of cancer attributable to smoking worldwide from 1990 to 2021: an analysis of the global burden of disease study 2021 Zhong-liu Wei 1,2, Xin Zhou1, Xi-wen Liao 1, Yong-guang Wei1, Hua-sheng Huang1, Chen-lu Lan 1, Hai-xiang Xie 1 and Tao Peng1,3,4* Abstract Objective This study aims to analyze global trends in cancer deaths and disability-adjusted life years (DALYs) attributable to smoking from 1990 to 2021 using the Global Burden of Disease (GBD) database, and to predict trends over the next 20 years. Methods This study utilized the 2021 GBD database to extract annual mortality, DALYs, and age-standardized rates for cancer attributable to smoking across 204 countries from 1990 to 2021. Joinpoint regression assessed temporal trends, calculating average annual percentage change (AAPC) . Autoregressive Integrated Moving Average (ARIMA) modeling forecasted future disease burden for 20 years. Results From 1990 to 2021, global cancer attributable to smoking deaths and DALYs increased, with deaths rising from 1,328 .88 to 2,012 .85 thousand and DALYs from 35,581 . 64 to 47,976 . 55 thousand, despite declining agestandardized mortality (ASMR) from 33.76 to 23.31 per 100,000 (AAPC: -1 . 19) and DALYs (ASDR) from 863.94 to 546.86 per 100,000 (AAPC: -1 .47) . Males exhibited a higher burden, with ASMR at 42.68 and ASDR at 978.15 per 100,000 in 2021, compared to females (7 .01 and 161. 30) . High Socio-demographic Index (SDI) regions showed the steepest ASMR decline (AAPC: -1 . 80) . Tracheal, bronchus, and lung, esophageal, and stomach cancers dominated the burden. In 2021, specific regions within Greenland, Eastern Europe, Central Asia, East Asia, and the Middle East demonstrated notably higher compared to other regions. The ARIMA model predicts that the ASMR and ASDR for cancer attributable to smoking in both males and females will continue to decline from 2022 to 2041. Conclusion This study reveals a rising global burden of cancer attributable to smoking deaths and DALYs. However, ASMR and ASDR have decreased, with males bearing a higher burden, indicating a relative reduction in disease burden. High SDI regions exhibit steeper declines in the burden of cancer attributable to smoking. Tracheal, bronchus, and lung, esophageal, and stomach cancers dominate, with ARIMA forecasts predicting continued reductions *Correspondence: Tao Peng [pengtaogmu@163.com](pengtaogmu@163.com); [pengtao@gxmu.edu.cn](pengtao@gxmu.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.) Wei et al. World Journal of Surgical Oncology (2026) 24:91 Page 2 of 13 th

FAQs

What is the main objective of this study?

The study analyzes global trends in cancer deaths and DALYs attributable to smoking from 1990 to 2021 using the GBD database and predicts trends for the next 20 years.

How were trends and future burden projections estimated?

Annual mortality, DALYs, and age-standardized rates for 204 countries were analyzed with Joinpoint regression to compute AAPC, and ARIMA modeling to forecast disease burden for 20 years.

What were the key findings from 1990 to 2021?

Global smoking-attributable cancer deaths and DALYs increased, while age-standardized mortality (ASMR) and age-standardized DALYs (ASDR) decreased.

Which cancers and regions showed notable patterns in the burden?

Tracheal, bronchus, and lung, esophageal, and stomach cancers dominated the burden; in 2021, specific regions within Greenland, Eastern Europe, Central Asia, East Asia, and the Middle East showed higher burdens than other regions.

Sep 22, 2026

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