Global and national burden of laryngeal cancer from 1990 to 2021 and future projections to 2045

Laryngeal cancer poses a persistent global health burden. Although age-standardized rates have declined, absolute case numbers continue to rise due to population growth and aging. To assess global, regional, and national trends in laryngeal cancer burden (1990–2021), evaluate disparities by Socio-demographic Index (SDI), and project future trends to 2045. We used data from the Global Burden of Disease 2021 study. Trends in incidence, mortality, prevalence, and DALYs were analyzed using estimated annual percentage change (EAPC). Das Gupta decomposition assessed contributions of aging, population growth, and epidemiological shifts. Frontier analysis evaluated control efficiency across SDI levels. Forecasts were generated using a Bayesian age-period-cohort (BAPC) model selected by root mean square error. From 1990 to 2021, age-standardized rates declined, but absolute burden increased. Middle-SDI regions and males bore disproportionately high burden. Low-SDI areas saw increases mainly from demographic drivers, while high-SDI areas saw reductions from improved epidemiology. Frontier analysis showed widening control inefficiencies. An inverted U-shaped SDI-burden pattern was identified. Projections indicate continued increases in absolute burden by 2045. Despite falling rates, global laryngeal cancer burden is growing. Targeted, SDI- and sex-specific interventions are needed to reduce disparities and improve outcomes.