Age-adjusted Lung Cancer Mortality Research Articles

Abstract C008: Associations of county-level structural racism indices with cancer mortality disparities in Florida

Abstract Existing multidimensional measures of structural racism are largely measured on the state level, which may mask underlying heterogeneity on smaller levels of geography. This study pilots an empirical approach to operationalizing structural racism in cancer equity research by introducing an association-sensitive inequality index developed to capture county-level structural racism, utilizing the state of Florida as an empirical case study. Three structural racism indices per county were constructed, incorporating comparisons between (a) non-Hispanic/Latinx Blacks and non-Hispanic/Latinx whites, (b) Hispanics/Latinx and non-Hispanic/Latinx whites, and (c) non-Hispanic/Latinx Blacks and Hispanics/Latinx. Unadjusted and adjusted regression models were fit to assess the ecological association between the structural racism indices and race/ethnicity-specific measures of (1) age-adjusted all-cause mortality, (2) age-adjusted overall cancer mortality, (3) age-adjusted lung cancer mortality, (4) age-adjusted breast cancer mortality, and (5) prevalence of late stage cancer diagnosis. Unadjusted and adjusted Poisson regression models were fit to assess the ecological association between the structural racism indices and race/ethnicity-specific measures of (1) age-adjusted all-cause mortality, (2) age-adjusted overall cancer mortality, (3) age-adjusted lung cancer mortality, (4) age-adjusted breast cancer mortality, and (5) prevalence of late stage cancer diagnosis. In fully adjusted models, county-level Black-white structural racism was associated with higher levels of all-cause, overall cancer, lung cancer, and breast cancer mortality rates among Black residents (p<0·0001), higher levels of all-cause mortality in white residents (p<0·0001). County- level Latinx-white structural racism was associated with lower levels of all-cause and overall cancer mortality and slightly higher lung cancer mortality among Hispanic/Latinx residents, and higher levels of all-cause mortality and lower levels of overall cancer mortality among white residents. This study provides evidence of structural racism impacts among cancer disparities within Black and Hispanic/Latinx communities, an understudied population in empirical structural racism literature. Study findings demonstrate that the relationship between the Black-white structural racism index and the health outcomes of interest correspond best with a “universal harm” relationship, whereby both Black and white Floridians experienced increased negative health outcomes associated with increasing levels of structural racism. Citation Format: Zinzi D. Bailey, Marlene Camacho-Rivera, Kasim Ortiz. Associations of county-level structural racism indices with cancer mortality disparities in Florida [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C008.

Abstract C095: County-level disparities in lung cancer mortality rates by sex for non-Hispanic Blacks and non-Hispanic Whites residing in the United States

Abstract Background: Lung cancer is the deadliest cancer in the United States and mortality rates are highest for Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) individuals compared to other racial groups. Additionally, lung cancer mortality rates are higher in men compared to women. However, county-level data for lung cancer mortality rates have not been studied in NHB and NHW populations stratified by sex. Further insight into county-level data disparity rates will provide stakeholders with tailoring and prioritizing community-based interventions to reduce lung cancer mortality disparities. Methods: Data from the 2015-2019 Centers for Disease Control and Prevention, United States Cancer Statistics were used to identify counties with age-adjusted lung cancer mortality rates for NHB and NHW males and females. Comparator groups were the general population for NHB and NHW, NHB vs. NHW females, and NHB vs. NHW males. Relative risk (RR) was used to determine the disparities in mortality rates between comparator groups in each county. A chi-square test was performed to identify the p-value between comparator groups. Results: Data were available for 336 counties across 40 states in the U.S. Overall, the majority of counties (N=172) demonstrated that NHBs had higher lung cancer mortality rates compared to NHWs with a mean RR of 1.24 (1.01-2.31). However, when stratified by sex, NHW females exhibited higher lung cancer mortality rates across the majority of counties (N=225) with a mean RR of 1.38 (1.01-2.7) compared to NHB females. North Carolina (N=25) and Texas (N=10) had the most counties experiencing disparities in lung cancer mortality rates between NHW and NHB females respectively. However, Dane County, Wisconsin had the highest disparity in mortality rates for NHB females compared to NHW females, RR:2.14 (p=0.001), and Middlesex County, Massachusetts had the highest disparity in mortality rates for NHW females compared to NHB females, RR:2.7 (p=0.002). NHB males exhibited higher lung cancer mortality rates across the majority of counties (N=230) with a mean RR of 1.34 (1.01-2.73) compared to NHW males. North Carolina had the most counties experiencing disparities in lung cancer mortality rates in NHW (N=13) and NHB (N=21) males. However, the District of Columbia had the highest disparity in mortality rates for NHB males compared to NHW males, RR: 2.73 (p=0.0001), and Petersburg County, Virginia had the highest disparity in mortality rates for NHW males compared to NHB males, RR:3.18 (p=<0.0001). Conclusion: Lung cancer mortality disparities are occurring throughout the United States for NHW and NHB females and males with the highest disparity in Middlesex County, Dane County, Petersburg County, and the District of Columbia respectively. However, consistent data highlighted a high prevalence of counties in North Carolina demonstrating lung cancer mortality disparities for all groups, except for NHB females. Future research and interventions are needed to understand the social and structural factors associated with mortality differences within these areas. Citation Format: Shanada Monestime. County-level disparities in lung cancer mortality rates by sex for non-Hispanic Blacks and non-Hispanic Whites residing in the United States [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C095.

Explaining spatial patterns of lung cancer mortality in Russia

ABSTRACT Socialization theory assumes that socialization agents, such as family, school, and church, inculcate human values and behaviors. The current study proposes that socialization has affected social acceptability of tobacco use. The analysis identifies socio-demographic risk factors, as measured in two postwar Soviet censuses, for age-adjusted lung cancer mortality in Russia in 2014−2018, using findings from the micro-level. Based on the 1959 and 1970 National Census results, three pairs of principal components were extracted corresponding to three socialization agents. A general-to-specific strategy was used to specify a spatial model and resulted in a spatial autoregressive model with autoregressive disturbances. Four spatial models show consistently that the strength of informal institutions in the postwar societies (i.e. at the socialization stage) was spatially related to a lower age-adjusted lung cancer mortality in men and women. Also, urban style of living and low education in the postwar societies were spatially related to an elevated age-adjusted lung cancer mortality in men. It is concluded that socialization theory can explain spatial variation in age-adjusted lung cancer mortality. The observed latitudinal spatial clustering of age-adjusted lung cancer mortality in the European part of the country remains consistent with the previous research on the spatial variation in violent mortality and suicide mortality.

Assessment on the influential factors of Radon exposure from school and residential Radon surveys in Korea

TPS 782: Health effects of emf, radiation and light, Johan Friso Foyer, Floor 1, August 28, 2019, 3:00 PM - 4:30 PM Background: Radon(222Rn) exposure is the second leading cause of lung cancer. For effective community-level Radon control policies, figuring out the main influential factors affecting Radon exposure and determining the representative value of Radon is important. However, little research has been conducted on recent national Radon surveys in Korea. Objective: To identify 2 main influential factors affecting Radon exposure (geologic factors and building types) using recent school & residential Radon survey data of South Korea and to analyze the association of Radon exposure with lung cancer mortality. Methods: Based on the school(2008~2009) & residential Radon data(2011~2016) from the Korean ministry of Environment, we compared the exposure variation of Radon levels among building types and inferred the amount of geologic influence through Spearman correlation coefficients(We are waiting for additional soil-Radium data and will use it to validate the geologic influence of Radon). Furthermore, we chose ‘detached house (2011~2016)’ as a building type that might maintain consistency in building structures regardless of the location of the buildings. After considering seasonal and temporal variation of exposure, we conducted a Poisson regression analysis to assess the association between regional Radon exposure of detached houses and age adjusted lung cancer mortality rates (2017) controlling for sex and smoking rates. Results: Similar regional exposure variations and moderate & high correlations (r>0.5) between building types indicate high geologic influence on Radon exposure. Despite controlling for potential confounders, the Poisson regression showed no significant associations of Radon and lung cancer (RR=1.001,95%CI:0.999-1.003). Conclusions: The influence of geologic factors and building types on Radon exposure is evident but insignificant association of Radon and lung cancer mortality rates may indicate the inappropriateness of using cross sectional Radon data to represent the whole cumulative exposure of a certain community. To effectively represent the exposure, data that involves housing population and valid exposure duration may be necessary.

Smoking and Lung Cancer Mortality in the United States From 2015 to 2065: A Comparative Modeling Approach.

Tobacco control efforts implemented in the United States since the 1960s have led to considerable reductions in smoking and smoking-related diseases, including lung cancer. To project reductions in tobacco use and lung cancer mortality from 2015 to 2065 due to existing tobacco control efforts. Comparative modeling approach using 4 simulation models of the natural history of lung cancer that explicitly relate temporal smoking patterns to lung cancer rates. U.S. population, 1964 to 2065. Adults aged 30 to 84 years. Models were developed using U.S. data on smoking (1964 to 2015) and lung cancer mortality (1969 to 2010). Each model projected lung cancer mortality by smoking status under the assumption that current decreases in smoking would continue into the future (status quo trends). Sensitivity analyses examined optimistic and pessimistic scenarios. Under the assumption of continued decreases in smoking, age-adjusted lung cancer mortality was projected to decrease by 79% between 2015 and 2065. Concomitantly, and despite the expected growth, aging, and longer life expectancy of the U.S. population, the annual number of lung cancer deaths was projected to decrease from 135000 to 50000 (63% reduction). However, 4.4 million deaths from lung cancer are still projected to occur in the United States from 2015 to 2065, with about 20 million adults aged 30 to 84 years continuing to smoke in 2065. Projections assumed no changes to tobacco control efforts in the future and did not explicitly consider the potential effect of lung cancer screening. Tobacco control efforts implemented since the 1960s will continue to reduce lung cancer rates well into the next half-century. Additional prevention and cessation efforts will be required to sustain and expand these gains to further reduce the lung cancer burden in the United States. National Cancer Institute.

Reduced Lung Cancer Mortality With Lower Atmospheric Pressure.

Background:Research has shown that higher altitude is associated with lower risk of lung cancer and improved survival among patients. The current study assessed the influence of county-level atmospheric pressure (a measure reflecting both altitude and temperature) on age-adjusted lung cancer mortality rates in the contiguous United States, with 2 forms of spatial regression.Methods:Ordinary least squares regression and geographically weighted regression models were used to evaluate the impact of climate and other selected variables on lung cancer mortality, based on 2974 counties.Results:Atmospheric pressure was significantly positively associated with lung cancer mortality, after controlling for sunlight, precipitation, PM2.5 (µg/m3), current smoker, and other selected variables. Positive county-level β coefficient estimates (P < .05) for atmospheric pressure were observed throughout the United States, higher in the eastern half of the country.Conclusion:The spatial regression models showed that atmospheric pressure is positively associated with age-adjusted lung cancer mortality rates, after controlling for other selected variables.

Pollution and regional variations of lung cancer mortality in the United States

IntroductionThe aims of this study were to identify counties in the United States (US) with high rates of lung cancer mortality, and to characterize the associated community-level factors while focusing on particulate-matter pollution. MethodsWe performed a descriptive analysis of lung cancer deaths in the US from 2004 through 2014. We categorized counties as “clustered” or “non-clustered” – based on whether or not they had high lung cancer mortality rates − using novel geospatial autocorrelation methods. We contrasted community characteristics between cluster categories. We performed logistic regression for the association between cluster category and particulate-matter pollution. ResultsAmong 362 counties (11.6%) categorized as clustered, the age-adjusted lung cancer mortality rate was 99.70 deaths per 100,000 persons (95%CI: 99.1–100.3). Compared with non-clustered counties, clustered counties were more likely in the south (72.9% versus 42.1%, P<0.01) and in non-urban communities (73.2% versus 57.4, P<0.01). Clustered counties had greater particulate-matter pollution, lower education and income, higher rates of obesity and physical inactivity, less access to healthcare, and greater unemployment rates (P<0.01). Higher levels of particulate-matter pollution (4th quartile versus 1st quartile) were associated with two-fold greater odds of being a clustered county (adjusted OR: 2.10; 95%CI: 1.23–3.59). ConclusionWe observed a belt of counties with high lung mortality ranging from eastern Oklahoma through central Appalachia; these counties were characterized by higher pollution, a more rural population, lower socioeconomic status and poorer access to healthcare. To mitigate the burden of lung cancer mortality in the US, both urban and rural areas should consider minimizing air pollution.

Lung cancer in South Africa: a forecast to 2025 based on smoking prevalence data

ObjectiveThis study aims to forecast lung cancer mortality with respect to recent changes in smoking prevalence and compares the results to estimates from GLOBOCAN and the Global Burden of Disease...

Clustering Curves based on Change point analysis : A Nonparametric Bayesian Approach

Statistical methods for analyzing disease incidence and mortality data over time and geographical regions have gained considerable interest in recent years due to increasing concerns of public health, health disparity and legitimate resource allocation. Trend analysis of cancer incidence and mortality rates is essential for subsequent public health investigations. For example, the National Cancer Institute provides software for fitting statistical models to track changes in cancer curves. Currently available models for detecting trend changes over time are designed for a single curve. When multiple curves are available, current methods could be applied multiple times, however, this may not be efficient in the statistical sense. This paper proposes a statistical model that allows concurrent change-point estimation and grouping for multiple curves while maintaining local variabilities. The Bayesian analysis is carried out by eliciting a Dirichlet process prior on the relevant func- tional space to model change-points. Improper priors are elicited and the resulting posterior is shown to be valid and proper. The age-adjusted lung cancer mortality rates of U.S. states are analyzed to detect change-points and rates of change as well as clusters of states that share similar trends over time. The procedure is also compared with an approach that group states according to a penalized likelihood

Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007.

Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. An observational study was conducted using INCA's database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance - pertaining to smokers and non-smokers - were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages. Smoking cessation must be stimulated in a disseminated manner in the population in order to avoid new cases of lung cancer. The Tumors in Initial Stages Group stood out with greater chances of cure.

The Effect of Provider Density on Lung Cancer Survival Among Blacks and Whites in the United States

Lung cancer mortality rates may vary with access to specialty providers and local resources. We sought to examine the effect of access to care, using density of lung cancer care providers, on lung cancer mortality among blacks and whites in the United States. We examined U.S. county-level data for age-adjusted lung cancer mortality rates from 2003 to 2007. Our primary independent variable was per capita number of thoracic oncologic providers, adjusting for county-level smoking rates, socioeconomic status, and other geographic factors. Data were obtained from 2009 Area Resource File, National Center for Health Statistics, and the County Health Rankings Project. Providers of lung cancer care were unevenly distributed among the U.S. counties. For example, 41.4% of the U.S. population reside in counties with less than four thoracic surgeons per 100,000 people, 23.4% in counties with 4 to 15 surgeons per 100,000 people, and 35.3% in counties with more than 15 surgeons per 100,000 people. Geographically, 4.3% of whites compared with 11.2% of blacks lived in high lung cancer mortality zones. Lung cancer mortality did not vary by density of thoracic surgeons or oncology services; however, higher primary care provider density was associated with lung cancer mortality reduction of 4.1 per 100,000 for whites. Variation in provider density for thoracic oncology in the United States was not associated with a difference in lung cancer mortality. Lower mortality associated with higher primary care provider density suggests that equitable access to primary care may lead to reduced cancer disparities.

Lung Cancer in Brazil

Cancer is now the second leading cause of death in Brazil (after cardiovascular diseases) and a public health problem, with around 500,000 new cases in 2012. Excluding nonmelanoma skin cancer, lung cancer is the second most incident cancer type in men, with 17,210 expected new cases. In women, it is the fifth most incident cancer, with 10,110 expected new cases. The estimated age-adjusted lung cancer mortality rate is about 13/100,000 for men and 5.4/100,000 for women. Lung cancer rates in men increased until the early 1990s and decreased thereafter, especially in the younger population. In contrast, a steady upward trend was observed for women. The positive effects in men were probably due to the successful anti-tobacco campaign conducted in Brazil over the last decades, which led to a decrease in the adult smoking population, from 32% in the early 1980s to 17% in the 2000s. Although the Brazilian National Cancer Institute is strongly committed to providing excellence in multimodality care to cancer patients, limitations in availability and adequate geographic distribution of specialists and well-equipped cancer centers are evident. Major disparities in patient access to proper staging and state-of-the-art treatment still exist. Considering that World Health Organization (WHO) officials estimate that cancer will become the number one cause of death in most developing countries, including Brazil, in the next decades, it is highly recommended for government authorities to implement firm actions to face this tremendous challenge.

Trends in lung cancer mortality in South Africa 1995–2008

ObjectivesCancers remains a major cause of morbidity and mortality in the world today. The global burden of cancer is expected to continue to increase with much of the burden being...

Lung cancer mortality in Sub-Saharan Africa

GLOBOCAN 2008 is an important resource for cancerresearch and health policy. Mortality and incidence estimatesof crude rates, age-standardized rates and absolute number ofcases by country and sex for the year 2008 are provided. Weagree with their conclusion that ‘‘Already the majority of theglobal cancer burden now occurs in developing countries,these proportions will rise in the next decades if rates remainunchanged.’’ Given the demographic transition that isongoing in developing countries, the absolute numbers willalmost certainly rise in the future.In Sub-Saharan Africa (SSA), population-based data onlung cancer incidence or mortality are not available, exceptSouth Africa and smaller island states. GLOBOCAN uses

Cardiorespiratory Fitness And The Risk Of Lung Cancer Mortality In The Aerobics Center Of Longitudinal Study

PURPOSES: Previous studies have suggested that higher levels of physical activity may lower lung cancer risk, however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. METHODS: Men (N = 38,000), aged 20 to 84 years without history of cancer, received a preventive medical examination during 1974 - 2002. Mortality surveillance was completed through December 31, 2003. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). At baseline, all men were able to complete the exercise test to at least 85% of their age-predicted maximal heart rate. Using Cox regression analyses, we computed hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: During an average of 17 years of follow-up, 232 lung cancer deaths occurred. Age-adjusted lung cancer mortality rates per 10,000 man-yrs according to low, moderate, and high CRF groups were 7.3, 3.1, and 2.3 (trend P < 0.0001). After further control for baseline year of examination, BMI, smoking, alcohol intake, physical activity, and family history of cancer, HRs (95% CIs) for lung cancer deaths across low, moderate and high categories of CRF were: 1.0, 0.48 (0.35-0.67), and 0.43 (0.28-0.65) respectively. There was an inverse association between CRF and lung cancer death within former (trend P = 0.005) and current smokers (trend P = 0.0009), but not within never smokers (trend P = 0.14). After stratifying data by lung function, an inverse association between CRF and lung cancer death was observed both in lower (FEV1/FVC ≤70%) and in higher lung function, P for linear trend <0.05 for both. Joint analysis of smoking and fitness status revealed a significant 12 fold higher risk of death in current smokers (HR: 11.9; 95% CI: 6.0-23.6) with low CRF compared with never smokers who had high CRF. CONCLUSIONS: Although the potential for residual confounding by smoking could not be eliminated, these data suggest that CRF is associated with lower risk of lung cancer death among men. Continued study of CRF in relation to lung cancer, particularly among smokers, may further our understanding of this disease and reveal additional strategies for reducing its burden.

Lung cancer mortality is elevated in coal-mining areas of Appalachia

Previous research has documented increased lung cancer incidence and mortality in Appalachia. The current study tests whether residence in coal-mining areas of Appalachia is a contributing factor. We conducted a national county-level analysis to identify contributions of smoking rates, socioeconomic variables, coal-mining intensity and other variables to age-adjusted lung cancer mortality. Results demonstrate that lung cancer mortality for the years 2000-2004 is higher in areas of heavy Appalachian coal mining after adjustments for smoking, poverty, education, age, sex, race and other covariates. Higher mortality may be the result of exposure to environmental contaminates associated with the coal-mining industry, although smoking and poverty are also contributing factors. The knowledge of the geographic areas within Appalachia where lung cancer mortality is higher can be used to target programmatic and policy interventions. The set of socioeconomic and health inequalities characteristic of coal-mining areas of Appalachia highlights the need to develop more diverse, alternative local economies.

Lung Cancer Mortality Patterns in Women Resident in Different Urbanization Areas in Central Italy from 1987–2002

The aim of the study was to evaluate mortality lung cancer trends, as an indicator of female smoking trends, in women resident in different urbanization areas. Data on the 5782 female lung cancer deaths that occurred in Tuscany, Italy, during the period 1987-2002 were analyzed, using age-period-cohort models by areas at different urbanization levels. Trends were examined with a log-linear regression model, calculating the yearly estimated percent change. Empirical bayesian estimators of the ratios between observed and expected deaths by municipality were calculated for the most recent period and mapped. The age-adjusted lung cancer mortality rates increased from 1987 to 2002: estimated percentage change values were equal to 24.5% in the urban areas (P < 0.001) and 17.2% in the rural areas (P = 0.023). The age-period-cohort model analyses showed a statistically significant drift and non-linear cohort effects. The higher risk was observed for the birth cohort of women born around 1955 (RR, 5.25; 95% CI, 2.83-9.72). In the rural areas, no significant effects were observed, and the age model showed the best fit. In recent years, the risk appeared concentrated in 9 Tuscan municipalities, accounting more than 35% of the female urban population. The observed significant cohort effect in the age-period-cohort analyses for the urban areas reflects the social impact of living in these areas to induce smoking-related disease like lung cancer in women. The risk appeared particularly relevant in more recent and urbanized generations (women born around 1955), thereby suggesting urgent effective campaigns against smoking, gender dedicated, especially in urban areas.

Tendencias de la mortalidad por cáncer pulmonar en México, 1980-2000

To analyze trends in age-adjusted lung cancer mortality rates in Mexico for the period of 1980 through 2000. The trends were assessed using the adjusted rates of mortality from lung cancer, year of death, year of birth, age at death, state, and standard population. The standardized mortality rate and the index of potential years of life lost were used to compare incidence and premature deaths. The standardized mortality rate was analyzed by age groups according to the age at death (30-74 years), five-year observation period (1980-1999), and birth cohort (1910-1950). Nonparametric Spearman correlations were calculated for per capita tobacco consumption, social marginalization, and emigration. The adjusted mortality rate from lung cancer declined from 7.91 per 100 000 in 1989 to 5.96 per 100 000 in 2000. This pattern correlated with the reduction in per capita tobacco consumption, from 2.145 kg in 1959 to 0.451 kg in 1982. The latent period for the appearance of lung cancer in Mexico was 30 years. The male:female ratio was 2.4:1. The highest adjusted mortality rate was found in men who were 70-74 years old at the time of death. The adjusted mortality rates were low among the cohorts of persons born in 1945 or later, and those rates declined over the 1980-2000 period. The index of potential years of life lost and the incidence of premature death were greater among men. The mortality rates for the cohorts of men born between 1915 and 1940 showed a slight decline over the 1980-2000 period; beginning with men born in 1944 the rates increased slightly, mainly among men 30-34 and 35-39 years old at the time of death. For women the adjusted mortality rates were highest among those 75 or older; the rates gradually declined among the women born between 1945 and 1960, with the largest decrease among women 30-34 years old. The adjusted mortality rates varied according to the five-year observation period, the year of death, and birth cohort and gender. The correlation coefficient for the adjusted mortality rate by state and social marginalization was -0.70 (P = 0.00). There was no statistically significant correlation with the index of emigration (P = 0.56). Mortality from lung cancer has declined in Mexico. Morbidity and premature death due to lung cancer are greater in the states of northern Mexico.

Occupation and histopathology of lung cancer: A case‐control study in Rosario, Argentina

Background Male age-adjusted lung cancer mortality rate is high in Rosario City, Argentina (62.7 per 100,000). Methods Case-control study involving interviews with 367 male lung cancer patients and 576 controls. Results The histological distribution detected was: squamous cell 39%, adenocarcinoma 34%, small cell carcinoma 13%, and other or no specified cell type 14%. When comparing with the group unlikely to be exposed to occupational carcinogens, a 60% increase in risk was observed for the remaining occupations (P < 0.008). Risks were high for drivers (OR=1.9, CI: 1.1–4.0), construction (OR=2.5, CI: 1.0–5.9), and agricultural workers also (OR=1.8, CI: 1.1–3.1). In regard to squamous cell carcinoma, increased risks were observed in the metal industry, particularly in welders (OR=2.9, CI: 1.0–10.1) and mechanics (OR=1.8, CI: 0.9–4.2). Smoking was not a substantial confounding effect. Conclusions Occupational exposures partly account for the high lung cancer mortality rate among male residents of Rosario City. Am. J. Ind. Med. 36:437–443, 1999. © 1999 Wiley-Liss, Inc.

Cigarette Smoking and Lung Cancer Trends: A Light at the End of the Tunnel?

To update the epidemic curves for lung cancer in the United States by gender in relation to the temporal trends in adult current cigarette smoking prevalence. The design of the study was ecologic, based on population figures. Available data on the prevalence of current cigarette smoking from 1920 to 1990 were plotted in conjunction with age-adjusted lung cancer mortality rates from 1930 to 1992 for each sex. There was a strong temporal relationship between the curves for cigarette smoking prevalence and lung cancer mortality rate with approximately a 30-year population latency period in both men and women. The curves occurred later in women than in men. The lung cancer rate in men peaked in 1990 and then began to decline while the rate in women continued to rise. The temporal association between cigarette smoking prevalence and lung cancer mortality provides additional support for the causal relationship between smoking and lung cancer.