Abstract: Objective To analyze the incidence and mortality of lung cancer in Beilun District of Ningbo City in Zhejiang Province from 2020 to 2024, and provide a scientific basis for the prevention and control strategies of lung cancer. Methods This study was based on the tumor incidence and mortality surveillance data of Beilun District from 2020 to 2024. The crude incidence rate, crude mortality rate, age-standardized incidence rate and age-standardized mortality rate of lung cancer were calculated by gender and age. The JoinPoint software was used to analyze the changing trends of lung cancer incidence and mortality, and the average annual percent change (AAPC) of lung cancer incidence and mortality was calculated. Results From 2020 to 2024, a total of 3 496 cases of lung cancer were reported in Beilun District of Zhejiang Province (crude incidence rate 157.15/100 000, age-standardized incidence rate 106.28/100 000), and 1 077 deaths were recorded (crude mortality rate 48.42/100 000, age-standardized mortality rate 26.00/100 000). The crude incidence rate (164.83 per 100 000) and crude mortality rate (73.97 per 100 000) for males were both higher than those for females (150.06 per 100 000 and 24.70 per 100 000, respectively) (χ² = 4.60, P=0.032; χ² = 280.81, P<0.001). The average age of lung cancer onset and mortality showed upward trends (AAPC = 1.53%, 0.46%; t = 10.23, 3.27; P=0.002, 0.047). The incidence and mortality rates increased with age and peaked in the 70-74 age group (452.62/100 000) and the 80- 84 age group (402.63/100 000), respectively. Age-group analysis showed that only the incidence rate in the 50-54 age group and the mortality rates in the 60-64 and 70-74 age groups exhibited a downward trend over time (AAPC = -13.03%, -11.12%, -4.46%, P = 0.038, 0.048, 0.031), while no such trends were observed in other age groups. Conclusion The incidence of lung cancer among residents in Beilun District is relatively high, with a heavy disease burden and no obvious annual downward trend, presenting significant challenges in prevention and control. The government should implement measures including strengthening tobacco control and occupational protection for men, formulating personalized treatment plans for elderly patients, launching kitchen health campaigns and passive smoking intervention for women, and improving the tumor registration and follow-up system to achieve precise prevention and control of lung cancer by gender and age.