Abstract
BackgroundMany previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends.MethodsData were obtained from Shanghai Cancer Registry. Age‐standardized rates were calculated and average annual percent changes (AAPCs) were evaluated by Joinpoint regression. Age, period, and birth cohort effects were assessed by age‐period‐cohort models.ResultsFrom 1973 to 2010, compared with long‐time slowly increasing trend in women, male lung cancer incidence had significantly decreased between 2001 and 2009. After that lung cancer incidence rising sharply in women (AAPC = 14.13%, 95%CI: 2.68%‐26.86%, P = .016) and similar rising trends without statistical significance in men (AAPC = 2.96, 95%CI: −2.47%‐8.69%, P = .281) between 2010 and 2014. Age‐period cohort model showed the different patterns of period effects for lung cancer incidence between men and women. The period effects for lung cancer incidence showed rising effect for women, whereas there was decline effect for lung cancer incidence for men. On the other hand, the model showed a significant period effect in both genders with a similar fashion in mortality, yielding steady falling trends during the entire study period.ConclusionsThe distinctive patterns of lung cancer incidence between men and women may be attributable to significant period effects, which reflected the changes in public health policies or diagnostic practices and highlighted the urgent of continued monitoring of gender‐specific risk factors for lung cancer incidence.
Highlights
| BACKGROUNDChina is inhabited by one-fifth of the world's population and contributes to almost 40% of all the lung cancer new diagnoses and deaths worldwide in 2018.1 Lung cancer becomes the most common among cancers in men and ranks only second to breast cancer in women; while lung cancer is the leading cause of deaths for both genders in 2015.2 The incidence and mortality rates of lung cancer in China are higher than the worldwide average, imposing an enormous disease burden and presenting a significant public health issue in China.[3]
Many previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends
We provided a sketchy description for lung cancer incidence and mortality changes at first, including the number of newly diagnosed cases and deaths of lung cancer per year, crude annual incidence and mortality rates, and age standardized rates
Summary
China is inhabited by one-fifth of the world's population and contributes to almost 40% of all the lung cancer new diagnoses and deaths worldwide in 2018.1 Lung cancer becomes the most common among cancers in men and ranks only second to breast cancer in women; while lung cancer is the leading cause of deaths for both genders in 2015.2 The incidence and mortality rates of lung cancer in China are higher than the worldwide average, imposing an enormous disease burden and presenting a significant public health issue in China.[3]. Many previous studies reported distinctive patterns incidence of lung cancer between men and women, such as recent sharply increasing trends of female lung cancer incidence worldwide.[4,5,6,7] Dissimilar to those observed trends among women in Western European countries,[1] the rising lung cancer incidence rates in Chinese women, despite their very low smoking prevalence, are considered to reflect exposures to environmental risk factors,[8,9] as well as the increasing use of low-dose spiral computerized tomography (LDCT) screening.[7] there is a lack of studies examined the possible reasons for different patterns of lung cancer incidence between men and women. By using the long-term cancer registry data in urban Shanghai, we conducted population-based study, spanning 42 years, to explore the reasons for different patterns of lung cancer incidence by investigating the birth cohort effect (commonly a proxy for increased exposures to environmental risk factors, such as smoking and air pollution) and period effects (a surrogate for changes in public health policies or diagnostic practices, such as tobacco control policies)
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