Abstract
Trends in mortality from Hodgkin's disease between mid 1950s and the late 1980s have been analysed for 16 western European and seven eastern European countries. In all western countries there were substantial falls in mortality from the late 1960s onwards, for an overall mean decline of 50% in both sexes, although these falls were somewhat larger in Nordic countries (approaching 70% in Denmark and Sweden), and more limited (20 to 30%) in Portugal, Spain and Greece. The reductions in Hodgkin's disease mortality were evident both in younger (under 35) and middle age (35 to 64 years), as well as in children under 15 and, in several countries, in the elderly (above 65), too. They were persistent up to the most recent calendar periods, with no evidence of flattening off. The pattern of trends in Hodgkin's disease mortality was largely different in Eastern Europe. Among seven countries examined, some fall was observed only in Bulgaria and Czechoslovakia, but other countries showed no consistent pattern and there was some increase, too. In absolute terms, the reductions in Hodgkin's disease mortality in Western Europe correspond to the avoidance of over 3,000 deaths per year. This stresses the importance and urgency of improving the availability of currently defined knowledge and resources for treatment of Hodgkin's disease in Eastern Europe.
Highlights
Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milano, Italy; 3Registre vaudois des tumeurs, Institut universitaire de medecine sociale et preventive, Centre Hospitalier Universitaire Vaudois, Falaises 1, 1011 Lausanne, Switzerland; Summary Trends in mortality from Hodgkin's disease between mid 1950s and the late 1980s have been analysed for 16 western European and seven eastern European countries
Effective therapies for Hodgkin's disease have been available for over 30 years (Rosenberg, 1989). These therapeutic successes have been based on a combination and integration of better diagnostic methods to evaluate the extent of the disease, of technical advancements in radiotherapy and the development of combination chemotherapy
1978-82 has shown elevated rates in several Central and Eastern European countries (Yugoslavia, Switzerland, Czechoslovakia), with a 3- to 5-fold difference compared with the lower rate areas in France and Denmark (Levi et al, 1989)
Summary
Death certification numbers for Hodgkin's disease, stratified for sex and 5 year age groups for 30 European countries The declines in all age mortality from Hodgkin's disease between the late 1950s and the mid 1980s were around the overall mean of 50% in both sexes (Table I) and most countries, except for Nordic Countries Denmark and Sweden, whose fall approached 70%), and Portugal, Spain and Greece (with falls between 20 and 30%) These declines tended to start between the late 1960s and the early 1970s in most countries, and were evident both in MALES
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