Lung cancer mortality in European women: Trends and predictions
Introduction
Lung cancer mortality in men has been declining since the late 1980s in most European countries, with a fall by 17% (from 55.4 to 44.0/100,000 men) in the European Union (EU) as a whole between the peak in 1988 and the rates in the early 2000s [1], and a predicted additional 15% fall to 37.2/100,000 in 2012 [2]. In women, lung cancer mortality in Europe has been appreciably lower than in men [3], but upward trends were observed up to the early 2000s, with an approximate 50% increase since the mid 1960s in the EU (from 5.5 to 11.2/100,000 women overall and from 9.2 to 17.9/100,000 in middle-aged women) [4], [5]. Earlier and particularly sharp increases were observed in Denmark, Germany, Hungary, Poland, and the UK. In England and Wales a leveling off in overall rates was observed since the 1990s. Further, since the mid-late 1990s trends have been more favorable in young women from many European countries, suggesting that female lung cancer epidemic in Europe may not reach the rates found in the USA in the 1990s, i.e. over 25/100,000 women [6], [7], [8]. However, steady upward trends were still observed even in the youngest age groups in some southern European countries such as France and Spain [9].
To monitor the current and predict the future evolution of lung cancer epidemic in European women, we analyzed trends in mortality rates over the period 1970 and 2009 and provided estimates of lung cancer deaths and rates for the year 2015.
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Material and methods
We obtained official female death certification data for lung cancer from the World Health Organization (WHO) database [10] for 33 European countries in the period 1970–2009. The EU was defined as the 27 Member States in January 2007, with the exclusion of Cyprus for which data were available for a limited number of most recent years only. In a few countries, mortality data were missing for one or more calendar years. No interpolation was made for missing data except for the definition of the
Results
Table 1 gives the age-standardized mortality rates from lung cancer in women (at all ages and truncated at 35–64 and 20–44 years) in 33 European countries and in the EU as a whole, in 2000–04 and 2005–09, with the corresponding percent change. Between 2000–04 and 2005–2009, overall lung cancer mortality increased by 12% in the EU, from 11.3 to 12.7/100,000 women. Increases were observed in most European countries, with the exception of Belarus, Malta, the Russian Federation, and Ukraine. These
Discussion
The present updated analysis of lung cancer mortality trends in European women indicates a steady increase in rates up to most recent calendar years, with an average 2.3% annual increase overall and 3.0% in middle-age in EU women over the last decade. Our projections to 2015 indicate a further increase in mortality in major European countries, with the overall rate reaching 14/100,000 in EU women. Overall female lung cancer mortality has been increasing up to recent calendar years in most
Conflict of interest statement
The authors have no conflict of interest to declare.
Role of funding sources
This work was conducted with the contribution of the Italian Association for Cancer Research (AIRC grant no. 10264), the Italian and Swiss Leagues against Cancer, and the Swiss Foundation for Research against Cancer. The sponsor had no role in study design, collection, analysis and interpretation of data.
Acknowledgment
The authors thank Mrs. Ivana Garimoldi for editorial assistance.
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