OBJECTIVE: This study aimed to assess the burden of respiratory tract cancers in China, the United States, India, and worldwide from 1990 to 2021. Also, forecast the evolution of respiratory tract cancers deaths and DALYs burden during 2022 to 2050. STUDY DESIGN: An epidemiological analysis. METHODS: Based on the GBD 2021 data, this article analyzed and discussed the trends in burden of respiratory tract cancers in China, the United States, India, and the world from 1990 to 2021. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was used to forecast the evolution of respiratory tract cancers deaths and DALYs burden during 2022 to 2050. RESULTS: The ASR-Deaths and ASR-DALYs for laryngeal and TBL cancers decreased globally. The burden of disease for TBL cancer increased in China and India (AAPC: 0.38 and 0.69), especially among Chinese women, while laryngeal cancer declined in India (AAPC: -0.69). In contrast, the burden of disease for both cancers declined substantially in the United States (-1.82 AAPC for laryngeal cancer and - 1.74 AAPC for TBL). A notable gender disparity existed in the burden of respiratory tumors, with males experienced a higher disease burden compared to females. In terms of age, the peak incidence of respiratory tract cancers predominantly occurred among individuals aged 65-74, indicating a clear tendency towards a higher prevalence among this age group. Population growth and ageing were primary factors influencing the mortality burden of larynx cancer, whereas epidemiological shifts in TBL cancer markedly impacted DALYs. The forecasted results for ASR-Deaths and ASR-DALYs worldwide from 2022 to 2050 indicated a decline in the burden of both larynx and TBL cancers. However, the deaths and DALYs of TBL cancer in China will show an upward trend, especially for females. CONCLUSIONS: The disease burden of respiratory tract cancers is a global health issue that needs attention, and situations vary from country to country, requiring personalized measures. Global strategies must address aging populations and socioeconomic disparities to reduce inequities in high-burden regions.