Predicting lung cancer death in Africa and Asia: differences with WHO estimates

Abstract

Reliable cancer burden estimates are rarely available from most developing countries where cancer registration is lacking. This study provided estimates on the current and future number of lung cancer deaths in Indonesia, Vietnam and Ethiopia, and Sub-Saharan Africa at large. The number of lung cancer deaths was estimated from detailed smoking prevalence data (obtained from surveys among 8,726 rural individuals aged 25-74 years in Indonesia, Vietnam, and Ethiopia in 2005-2006) and on lung cancer rate estimates among non-smokers. Our estimate for lung cancer deaths in Sub-Saharan Africa is 44,076 in 2005, which is 2.6 times the most recent WHO estimate in 2003 (17,000 deaths). A similar ratio is found for the country-specific estimate in Ethiopia. Our estimates are only slightly higher than the WHO's in Indonesia, and Vietnam. The attributable risk of smoking for lung cancer death among men was 39% in Ethiopia, 80% in Indonesia and 85% in Vietnam. We expect the annual number of lung cancer deaths to double by 2025, even if the smoking prevalence is assumed not to increase further. WHO estimates on lung cancer deaths in Asia appear to be slightly lower than our study results; however, in Africa, the burden appears to be largely underestimated.