Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men.

Yon Jee,Jong-Keun Lee,Chang-Mo Oh,Aesun Shin

doi:10.3390/ijerph13121208

Abstract

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

Highlights

Cigarette smoking is the most important health problem worldwide, accounting for an estimated six million deaths annually—both from cancer and other diseases [1]
This study shows that birth cohorts born in the 1920–1930s had the highest smoking-related cancer mortality rate
Our study suggested that reduction in cigarette smoking was associated with a decrease in the mortality of oropharyngeal, laryngeal, esophageal, and lung cancer, which account for a large proportion of deaths

Summary

Introduction

Cigarette smoking is the most important health problem worldwide, accounting for an estimated six million deaths annually—both from cancer and other diseases [1]. In Korea, tobacco consumption increased from 1945—the year the Korean War ended—reaching a rate of 79.3% in men and 12.6% in women in the 1980s [2] before starting to decline. Cigarette smoking is recognized as a major risk factor for lung, oropharyngeal, esophageal, and laryngeal cancer and induce the misreplication of DNA. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to

Objectives

Methods

Results

Conclusion