Abstract
BackgroundHealth and social conditions vary between West and East Germany.MethodsWe analyzed annual mortality data of all recorded deaths caused by lung, colorectal, breast and prostate cancer in Germany as they are published by the Federal Bureau of Statistics (FBS) encompassing the period 1980–2014 for former West Germany (WG) and 1990–2014 for former East Germany (EG). To compare East and West Germany we computed the ratio of the mortality rates in both parts (mortality rate ratio, MRR, <1 indicates a lower mortality in EG). Forecasting methods of time series analyses were applied (model selection based on the Box/Jenkins approach) to predict 5-year trends until 2019.ResultsLung cancer: In women mortality rose in both regions (WG: +2.8%, 1991–2014, EG: +2.2%, 1990–2014). In men mortality in WG declined between −2.1% and −1.2%, and by −2.7% (1993–2009) in EG which was followed by a plateau. Colorectal cancer: A decline was found in both WG (−3.1%, 1993–2014) and EG women (−3.8%, 1993–2008 and −2.0%, 2008–2014). A decline in EG men since 1992 (−0.9%, 1992–1997 and −2.3%, 1997–2014) mirrors the development in WG (−2.6%, 1995–2014). Breast cancer: Constant mortality decline in WG after 1996. In EG a decline (−2.4%, 1992–2007) was followed by a plateau with an MRR <1 (1990–2014). Prostate cancer: In WG a decline (−3.4%) came to a hold after 2007, while there was a constant decline of 1.5% in EG. The forecast indicated that mortality of colorectal/lung cancer in men and breast cancer reaches a plateau in future years.ConclusionCourses of mortality were similar between East and West, while existing differences are likely to remain in the near future.
Highlights
Health and social conditions vary between West and East Germany
Lung cancer We estimated a constant growth of lung cancer mortality for German women overall
The site-specific rise was higher for West German women (Table 2) with an annual increase of 2.8% than for East German women (Table 1) at 2.2%
Summary
Health and social conditions vary between West and East Germany. Cancer survival is not spread evenly over the continent. While 5-year age and cancer site case-mix standardized relative survival rate (ACRS) appears to be lowest in Bulgaria for both men (32%) and women (47%), Austrian men (53%) and Icelandic women (61%) currently have the highest chances of survival [2]. Overall there is an approximately 9% lower probability of 5-year survival in Eastern Europe compared to Central Europe. One reason for this discrepancy might be found in differing socioeconomic welfare and health funding [3, 4]. The reunification of Germany in 1990 led to the establishment of a markedly different political and economic system in the East, influencing a renewal in general health care
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