BackgroundAlthough oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours.MethodsSpecific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures.ResultsAmong men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950–1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer.ConclusionsWhile the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.

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BackgroundIn Spain, cervical cancer prevention is based on opportunistic screening, due to the disease’s traditionally low incidence and mortality rates. Changes in sexual behaviour, tourism and migration have, however, modified the probability of exposure to human papilloma virus among Spaniards. This study thus sought to evaluate recent cervical cancer mortality trends in Spain.MethodsWe used annual female population figures and individual records of deaths certified as cancer of cervix, reclassifying deaths recorded as unspecified uterine cancer to correct coding quality problems. Joinpoint models were fitted to estimate change points in trends, as well as the annual (APC) and average annual percentage change. Log-linear Poisson models were also used to study age-period-cohort effects on mortality trends and their change points.Results1981 marked the beginning of a decline in cervical cancer mortality (APC1981–2003: −3.2; 95% CI:-3.4;-3.0) that ended in 2003, with rates reaching a plateau in the last decade (APC2003–2012: 0.1; 95% CI:-0.9; 1.2). This trend, which was observable among women aged 45–46 years (APC2003–2012: 1.4; 95% CI:-0.1;2.9) and over 65 years (APC2003–2012: −0.1; 95% CI:-1.9;1.7), was clearest in Spain’s Mediterranean and Southern regions.ConclusionsThe positive influence of opportunistic screening is not strong enough to further reduce cervical cancer mortality rates in the country. Our results suggest that the Spanish Health Authorities should reform current prevention programmes and surveillance strategies in order to confront the challenges posed by cervical cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1306-x) contains supplementary material, which is available to authorized users.