Abstract
Introduction. Cancer is the second cause-of-death mortality pattern in the Republic of Moldova. The study of both cancer mortality by age and its detailed causes is an important tool for evidence-based public health policy. The study aims at comparing recent changes in cancer mortality with long-term trends, depending on specific causes and age. Material and methods. This study was carried out on the reconstructed 1965-2018 death time series, according to the 10th revision of the International Classification of Diseases. Standardized death rates were computed. Results. After a gradual increase in the ‘70s and ‘80s of the last century, cancer mortality rate showed “reversed” patterns and started to decline in the ‘90s. This decline was due to the data quality issue and to the competing risks of dying from other causes sensitive to the social and economic circumstances of the ‘90s. Since the beginning of the millennium, cancer mortality has resumed its growth that continues up to now. Despite the increasing overall trend in cancer mortality rate during 1965-2018, the analysis by age and specific causes revealed opposite trends. Conclusions. The malignant neoplasms specific for certain sites and age groups (stomach, uterus, leukaemia in children) showed, however some therapeutic progress, while the situation for other tumour sites (lung, breast, and intestine) worsened significantly. The moderate decrease in lung cancer in the 1990s should be cautiously interpreted.
Highlights
Cancer is the second cause-of-death mortality pattern in the Republic of Moldova
The stagnation of life expectancy in Moldova is explained by a continuous increase in adult mortality from non-communicable diseases, the cardiovascular diseases being the first and foremost among all deaths due to injury and poisoning, which was partially compensated by a decrease in infant and child mortality
This present research was based on the cause-ofdeath time series for the Republic of Moldova reconstructed by the author [12] and published in The Human Cause-of-Death Database (HCD) over 1965-2014 years [13] and extended up to 2018 (Penina, unpublished)
Summary
Cancer is the second cause-of-death mortality pattern in the Republic of Moldova. The study of both cancer mortality by age and its detailed causes is an important tool for evidence-based public health policy. The considerable half-century increase in mortality due to cardiovascular disease or injury and poisoning dropped down as a result of the 1985 anti-alcohol campaign and the severe socioeconomic crisis of the 1990s occurring across the country after the USSR collapse These short-term rises and falls and the relatively stable tendency in the overall cancer mortality, especially in females, were followed by a steady increase since the late 1990s. The latter period differs from the situation recorded in other FSU countries, as for example, the cancer death rate in Russia has revealed a decreasing tendency since the mid-1990s, which continues up to now, being mostly associated with lung cancer in males and stomach cancer [9]
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