Recent trends and future directions for lung cancer mortality in Europe

Abstract

Lung cancer mortality patterns throughout Europe are very heterogeneous and largely reflect past smoking habits. In order to clarify the changing patterns of lung cancer in Europe we have plotted the overall lung cancer trends among men and women for 20 countries from 1950 up to1998. Furthermore, using a Bayesian age-period-cohort approach, we have calculated 5 year projections of lung cancer rate up to 2003. Finally, we make some comments on probable future trends by analysing recent trends in adults aged 555 years. Lung cancer mortality rates up to age 75 years portray a general trend of decreasing lung cancer rates among men and increasing lung cancer rates among women. Exceptions to this decrease among men include Hungary where not only are current mortality rates much higher than previously observed in any other country (at 76.7 out of 100 000 in 1998) but they are projected to increase further in the short term. Rates among adults aged 555 years have recently peaked, indicating that overall rates are likely to peak in the next decade. Among women, rapid increases have been observed in Denmark, Netherlands, Hungary, Ireland and UK. Whereas Ireland and UK rates have started to decrease and are projected to continue falling, rates in the other three countries are projected to increase further. Trends in women aged 555 years indicate that rates in Danish women will peak in the next decade, whereas lung cancer rates among Dutch women are likely to continue increasing. Rates in Hungarian women are likely to increase and will surpass the current high rate observed in Denmark. British Journal of Cancer (2002) Lung cancer is the most common cause of cancer mortality among men in Europe, and is becoming an increasingly important cause of cancer mortality among women . Lung cancer mortality patterns throughout Europe are very heterogeneous and largely reflect past smoking habits (Kubik et al, 1995), although changes in cigarette composition are also likely to be important. In order to clarify the changing patterns of lung cancer in Europe we have plotted the overall lung cancer trends among men and women for 20 countries from 1950 up to the most recent collection of data, usually 1996 -1998, depending on each country. Furthermore, using a recently validated Bayesian age-period-cohort approach, we have calculated 5 year projections of lung cancer rate up to 2001 -2003. Given the delay of several years in obtaining cancer mortality data these short term projections serve as a measure of current lung cancer mortality. Finally, as changes in lung cancer rates tend to be observed first among younger age groups, we make some comments on likely future trends by analysing recent trends in adults aged less than 55 years. METHODSOfficial lung cancer mortality figures for 20 European countries, stratified for sex and 5 year age groups, were obtained from the WHO mortality database for the years 1950 -1998. Information from other European countries over this time period was not available. Information from the former-Czechoslova...

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