Objective  To examine changing trend in disease burden of lung cancer and related risk factors among residents in China from 1990 to 2019 for developing targeted strategies on lung cancer prevention and treatment.

  Methods  The open access data relevant to disease burden of lung cancer and its associates among Chinese residents in 1990, 2005 and 2019 were extracted from the Global Burden of Disease (GBD) Study 2019. We used years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life years (DALYs) to describe changes of lung cancer burden and population-attributable faction (PAF) to analyze the disease burden attributable to risk factors and epidemiological transition among the residents of various age groups from 1990 to 2019.

  Results  In 2019 among Chinese male residents, the rates (1/100 000) of YLDs, YLLs, and DALYs of lung cancer were 19.10, 1 632.03, and 1 651.13 and all the rates were higher than those of 8.73, 731.14, and 739.87 among Chinese female residents; the three rates increased with age, with the highest rates of 76.17, 5 243.52, and 5 319.70 in the residents aged 70 years and over. Compared to those in 1990, the rates of YLDs, YLLs, and DALYs increased by 3.61%, 2.49%, and 2.50%, respectively in 2019. Among the 16 known risk factors of lung cancer, the top five with highest contributions to DALYs (million person years), DALYs rate (1/10 000) and PAF were smoking (10.75, 755.91 and 62.06%), environmental particulate pollution (3.86, 271.20 and 22.47%), second-hand smoke (1.35, 94.81 and 7.86%), high fasting plasma glucose (1.11, 77.87 and 6.47%) and home air pollution due to solid fuel use (0.85, 59.72 and 4.94%). Of the PAF for the 16 known risk factors during the period of 1990 – 2019, the PAFs of 8 factors increased, with the highest increase of 110.12% for environmental particulate pollution and other 8 factors′ PAF decreased, with the lowest decrease of 77.74% for home air pollution due to solid fuel use.

  Conclusion  During 1990 – 2019 among residents in China, the disease burden of lung cancer was heavy and the YLDs, YLLs and DALYs rate of lung cancer increased; smoking is still a main risk factor for disease burden of lung cancer.