Geographic trends of tobacco-related cancers in Cyprus

Abstract

BackgroundCausal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural–urban classification to understand the impact of tobacco in Cyprus.MethodsData on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998–2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were conducted with regards to age at diagnosis, age groups, sex, smoking status, disease stage, and rural/urban status, with a p-value of 0.05 considered significant. Smoking prevalence, lung cancer, and bladder cancer rates of Cyprus were also compared to a number of other European countries.ResultsPatients with tobacco-related cancers were older than those with non-tobacco cancers (mean age 67.2 ± 12.4 vs. 62.4 ± 17.1, p < 0.0001). Among those with tobacco-related cancers, 80.1 % were male compared to 45.4 % males with other cancer types. The proportion of ever smokers was higher among males compared to females in urban and rural districts. Sub-districts 41 (Age Adjusted Rate (AAR) 41.9, 95 % CI: 35.7-48.1), 60 (AAR 40.3, 95 % CI: 35.2-45.3), and 50 (AAR 36.3, 95 % CI: 33.8-38.7) had the highest rates of tobacco-related cancers. The overall tobacco-related cancer rate was the highest among males in urban districts (AAR 60.8, 95 % CI: 58.2-63.5). Among tobacco-related cancers, lung cancer had the highest overall AAR (17.9 per 100,000) while head and neck cancer had the lowest overall AAR (5.3 per 100,000). Additionally, even though Cypriot males aged 65–69 years old exhibited higher smoking prevalence than other European countries, the overall lung and bladder cancer rates were lower in Cyprus.ConclusionDespite the high proportion of smokers in Cyprus, cancer rates are low compared to other countries. Future in-depth measurements of relevant risk factors and smoking exposure can help understand this phenomenon and provide insights for cancer prevention.

Epidemiology of lung cancer in Northern Greece: An 18- year hospital-based cohort study focused on the differences between smokers and non-smokers

“…Also, among our main findings was that age proved to be another significant risk factor for lung cancer development, as larger proportions of lung cancer incidence were observed among patients aged ≥50 years, in accordance with the literature 32,33 . In addition, as the vast majority of patients included in the present study were permanent residents of urban or semi-urban municipalities, occupational or environmental factors might have hidden effects on lung cancer development, as highlighted in other studies 14,34,35 . Furthermore, it has been reported that different smoking habits between rural and urban regions result in geographical inequalities in lung cancer incidence distribution 34 .…”

Lung cancer and tobacco smoking in Crete, Greece: reflections from a population-based cancer registry from 1992 to 2013

“…In addition, place of residence seems to be a core component of lung cancer incidence and mortality trends, as highlighted by the current and other studies [34, 35]. It is obvious that a wide range of factors, such as demographic, occupational and environmental, are linked with rurality.…”

“…It is obvious that a wide range of factors, such as demographic, occupational and environmental, are linked with rurality. These factors may have hidden effects on lung cancer epidemics; such effects are more severe in geographical regions where prevalence of smoking is higher (e.g., urban or semi-urban municipalities) [35]. Geographical inequalities in lung cancer incidence distribution may be observed due to the different smoking habits between rural and urban regions.…”

Tobacco-related cancers in India: A review of incidence reported from population-based cancer registries

“…A study from Cyprus reported TRCs in Cyprus and compared AARs in rural and urban districts and also compared the data with the data of many other European countries. [ 12 ] A study on upper gastrointestinal cancers clustering and geographical variation in North China found a difference in various geographical areas is due to regional differences. [ 13 ]…”