Elsevier

Lung Cancer

Volume 78, Issue 3, December 2012, Pages 171-178
Lung Cancer

Lung cancer mortality in European women: Trends and predictions

https://doi.org/10.1016/j.lungcan.2012.08.008Get rights and content

Abstract

Female lung cancer mortality increased by 50% between the mid 1960s and the early 2000s in the European Union (EU). To monitor the current lung cancer epidemic in European women, we analyzed mortality trends in 33 European countries between 1970 and 2009 and estimated rates for the year 2015 using data from the World Health Organization. Female lung cancer mortality has been increasing up to recent calendar years in most European countries, with the exceptions of Belarus, Russia, and Ukraine, with relatively low rates, and the UK, Iceland and Ireland, where high rates were reached in mid/late 1990s to leveled off thereafter. In the EU, female lung cancer mortality rates rose over the last decade from 11.3 to 12.7/100,000 (+2.3% per year) at all ages and from 18.6 to 21.5/100,000 (+3.0% per year) in middle-age. A further increase is predicted, to reach 14/100,000 women in 2015. Lung cancer mortality trends have been more favorable over the last decade in young women (20–44 years), particularly in the UK and other former high-risk countries from northern and central/eastern Europe, but also in France, Italy, and Spain where mortality in young women has been increasing up to the early 2000s. In the EU as a whole, mortality at age 20–44 years decreased from 1.6 to 1.4/100,000 (−2.2% per year). Although the female lung cancer epidemic in Europe is still expanding, the epidemic may be controlled through the implementation of effective anti-tobacco measures, and it will probably never reach the top US rates.

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.

Section snippets

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.

References (50)

  • M.P. Coleman et al.

    Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data

    Lancet

    (2011)
  • W.A. Zatonski et al.

    Convergence of male and female lung cancer mortality at younger ages in the European Union and Russia

    Eur J Public Health

    (2007)
  • F.I. Bray et al.

    Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970–2007

    Int J Cancer

    (2010)
  • C. Bosetti et al.

    Cancer mortality in Latin America: implications for prevention

    Rev Panam Salud Publica

    (2005)
  • A. Jemal et al.

    Annual report to the nation on the status of cancer, 1975–2005, featuring trends in lung cancer, tobacco use, and tobacco control

    J Natl Cancer Inst

    (2008)
  • C. Eheman et al.

    Annual Report to the Nation on the status of cancer, 1975–2008, featuring cancers associated with excess weight and lack of sufficient physical activity

    Cancer

    (2012)
  • F. Levi et al.

    Trends in lung cancer among young European women: the rising epidemic in France and Spain

    Int J Cancer

    (2007)
  • World Health Organization Statistical Information System. WHO mortality database. Available at:...
  • World Health Organization

    International classification of disease and related health problems

    (1992)
  • European Commission. Eurostat population database. Available at:...
  • R. Doll et al.

    Comparison between registries: age-standardized rates

  • H.J. Kim et al.

    Permutation tests for joinpoint regression with applications to cancer rates

    Stat Med

    (2000)
  • National Cancer Institute. Joinpoint Regression Program, version 3.5; 2011. Available at:...
  • A. Decarli et al.

    Age, period and cohort models: review of knowledge and implementation in GLIM

    Rivista Statistica Applicata

    (1987)
  • C. Osmond

    Using age period and cohort models to estimate future mortality rates

    Int J Epidemiol

    (1985)
  • Cited by (0)

    View full text