Patterns Of Lung Cancer Mortality Research Articles

1739P Lung cancer mortality patterns of tobacco users in the United States: A 21-year analysis (1999-2020)

1739P Lung cancer mortality patterns of tobacco users in the United States: A 21-year analysis (1999-2020)

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.

Análisis espacial de la mortalidad por cáncer de pulmón en España con especial referencia a Andalucía (2013-2017)

ObjectiveTo analyze the geographical pattern of lung cancer mortality according to sex in Spain (by provinces) and Andalusia (by municipalities) during the period 2013-2017. Subjects and methodThree risk estimators were used to analyze spatial patterns: standardized mortality ratio, relative risk smoothing (RRS), and posterior probability (PP) that RRS is greater than 1. We conducted a cluster analysis using global Moran's index and local Moran's index (LISA). The results were mapped. ResultsIn men, 17 provinces have an RRS greater than 1, 15 of which have a PP>0.95, including Huelva, Seville, Cadiz and some provinces in northern Spain (Asturias and Cantabria). In women, 10 provinces have an RRS>1 and PP>0.95, 6 located in northern Spain, Valladolid, Madrid, Valencia, and Alicante. In Andalusia, 332 municipalities in an area that includes 5 provincial capitals (Huelva, Seville, Cadiz, Malaga, and Almeria) show an RRS>1 among men. Thirty nine of these, mostly in the provinces of Huelva, Cadiz and Seville, have a PP>0.95. In women, only 22 municipalities have an RRS>1, although only 5 have a PP≥0.80 (one in Cadiz and 4 in Malaga) and none have PP>0.95. ConclusionsOur findings help identify high-risk areas to guide lung cancer mortality control efforts.

Five-year lung cancer mortality risk analysis and topography in Xuan Wei: a spatiotemporal correlation analysis

BackgroundIn Xuan Wei, China, the lung cancer mortality rate is rising significantly more than that of the nation overall. However, it remains unclear 1) if improved diagnosis can just partially explain this observation and how other local risk factors may be correlated with the lung cancer mortality rate and 2) how the lung cancer mortality rates differ within Xuan Wei and how these spatiotemporal patterns are linked with local risk factors. To increase etiological knowledge, this study evaluated the spatial and temporal distributions of the health effects (the lung cancer mortality rates) from 2011 to 2015.MethodsFour steps of spatial analysis were applied, as follows: 1) hotspot analysis to determine the geographical patterns of lung cancer mortality, 2) spatially-weighted sum to identify areas with higher health risks, 3) bivariate statistical analysis to assess the overall correlation between coal mines and lung cancer mortality, and 4) geographically-weighted regression to test for correlations among different towns within Xuan Wei.ResultsWomen had higher lung cancer mortality rates than those in men, with an increasing trend in both sexes over time. The incidence rates in Laibin Town were the highest in Xuan Wei every year. Over the 5-year study period, the lung cancer mortality was increasingly concentrated in Laibin, Shuanglong, and Longchang, where the smoky coal mines are most concentrated. The population-level health risks from the coal mine in Xuan Wei were mapped and divided into five types of risk areas (Type I – Type IV). Correlation analysis revealed that there was no significant correlation between lung cancer mortality as a whole and coal mine distribution during the 5-year study period. However, the geographically-weighted regression revealed a stronger correlation in medium (Type III) and second-lowest (Type IV) health risks.ConclusionsXuan Wei lung cancer mortality has increased continuously since the third national retrospective surveys on the causes of death by the Ministry of Health of the People’s Republic of China (2004–2005), especially for local women and residents over 35 years of age. Geographically, lung cancer in Xuan Wei showed unique spatiotemporal clustering. The local lung cancer mortality was significantly correlated with the smoky coal mine geographically. Some specific towns (Laibin, Shuanglong, and Longchang) within Xuan Wei manifested high correlations between lung cancer mortality and coal mines. The effects of coal mines on lung cancer mortality rates also spread geographically outward from these areas. Public health concern regarding lung cancer in Xuan Wei should prioritize higher-risk towns surrounded by smoking coal mines. Intervention strategies for particular toxic coal types require further studies on their chemical characteristics and mechanisms of carcinogenesis. Additional studies are also warranted to systematically examine the local environmental health risks related to coal industries and combustion air pollution and eventually to conduct early screening of lung cancer for local people who are more exposed to smoky coal in high-risk areas.

Validating the use of census data on education as a measure of socioeconomic status in an occupational cohort

Purpose Adjusting for smoking status or a reliable surrogate [such as socioeconomic status (SES)] is critically important in occupational epidemiology studies when any smoking-related cancer or cardiovascular disease is an outcome of interest. Sometimes, however, data on smoking patterns or individual-level smoking surrogates such as job title, education, pay scale or other measures of SES are not readily available in occupational cohorts. Methods and materials To obtain a surrogate measure for missing smoking or individual-level SES data, we demonstrate a method used to obtain and geocode residential address histories which were then linked to area-level SES measures from the United States Census in three test samples and then in a full cohort of workers from the Mound nuclear weapons facility in Dayton, Ohio, USA. The mean educational attainment of the Census Block Group was used to derive a categorical estimate of educational attainment which was compared to self-reported (SR) education available from Mound worker histories using Kappa statistics. Lung cancer mortality patterns between area-derived (AD) and SR education were investigated using Standardized Mortality Ratios (SMR) and Cox Proportional Hazards models with stratification or adjustment by either SR or AD education. Results Home address histories were obtained from linkages of individual worker data to online resources. In the test cohorts, mean educational attainment was the Census Block Group measure found to have the largest magnitude association with individual-level SES measures. Among 7251 Mound workers, 5685 (78.4%) had at least one residential address match (mean 4.9 addresses) identified. The SR and AD educational attainment measures were highly correlated (weighted Kappa coefficient 0.10, p < .0001). SMR patterns by SR and AD educational attainment were similar, with steadily decreasing mortality with increased educational attainment by either measure. Cox models for lung cancer using AD education produced similar results as those using SR education as an adjustment factor. Conclusion When individual-level SES indicators are not available for statistical adjustment, area-level SES measures can serve as a reliable surrogate when investigating outcomes that are affected by lifestyle factors such as smoking.

Patterns of lung cancer mortality in Russia, 2000-2015

Patterns of lung cancer mortality in Russia, 2000-2015

Patterns of lung cancer mortality in Russia, 2000-2015

Patterns of lung cancer mortality in Russia, 2000-2015

Sex patterns of lung cancer mortality in Russia over a 16-year period, 2000-2015

Sex patterns of lung cancer mortality in Russia over a 16-year period, 2000-2015

Risk patterns of lung cancer mortality in northern Thailand

BackgroundOver the past decade, lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have consequently become more important in this region. Spatial analysis studies may be helpful in guiding any strategy put in place to respond to the risk of lung cancer mortality in specific areas. The aim of our study was to identify risk patterns for lung cancer mortality within the northern region of Thailand.MethodsIn the spatial analysis, the relative risk (RR) was used as a measure of the risk of lung cancer mortality in 81 districts of northern Thailand between 2008 and 2017. The RR was estimated according to the Besag-York-Mollié autoregressive spatial model performed using the OpenBUGS routine in the R statistical software package. We presented the overall and gender specific lung cancer mortality risk patterns of the region using the Quantum Geographic Information System.ResultsThe overall risk of lung cancer mortality was the highest in the west of northern Thailand, especially in the Hang Dong, Doi Lo, and San Pa Tong districts. For both genders, the risk patterns of lung cancer mortality indicated a high risk in the west of northern Thailand, with females being at a higher risk than males.ConclusionsThere was distinct geographical variation in risk patterns of lung cancer mortality in Thailand. Differences could be related to differences in risk factors such as ground-based radon and air pollution. This study provides a starting point for estimating the spatial pattern of the risk of lung cancer mortality and for examining associations between geographic risk factors and lung mortality for further studies.

Patterns of lung cancer mortality in Russia over a 16-year period, 2000-2015

Patterns of lung cancer mortality in Russia over a 16-year period, 2000-2015

Lung cancer mortality clusters in Shandong Province, China: how do they change over 40 years?

Lung cancer has long been a major health problem in China. This study aimed to examine the temporal trend and spatial pattern of lung cancer mortality in Shandong Province from 1970 to 2013. Lung cancer mortality data were obtained from Shandong Death Registration System and three nationwide retrospective cause-of-death surveys. A Purely Spatial Scan Statistics method with Discrete Poisson models was used to detect possible high-risk spatial clusters. The results show that lung cancer mortality rate in Shandong Province increased markedly from 1970-1974 (7.22 per 100,000 person-years) to 2011-2013 (56.37/100, 000). This increase was associated with both demographic and non-demographic factors. Several significant spatial clusters with high lung cancer mortality were identified. The most likely cluster was located in the northern region of Shandong Province during both 1970-1974 and 2011-2013. It appears the spatial pattern remained largely consistent over the last 40 years despite the absolute increase in the mortality rates. These findings will help develop intervention strategies to reduce lung cancer mortality in this large Chinese population.

“You’ve Come a Long Way, Baby”: The Convergence in Age Patterns of Lung Cancer Mortality by Sex, United States, 1959–2013

ABSTRACTWe analyze lung cancer mortality by age and sex in the United States, 1959–2013. It is already known that male lung cancer death rates exceed those of women and that tobacco use is the leading reason for the sex difference. We elaborate on this knowledge by showing that unlike most causes of death, lung cancer mortality patterns by age are a very good fit to a quadratic-Gompertz model, i.e., log mortality rates are quadratic by age, with the mode above age 70. With a little additional historical data on sex differences in tobacco use, the quadratic models help to paint a clear quantitative picture of behavior-led convergence in lung cancer mortality by sex. The shape of the sex-specific mortality curves have converged dramatically: since 1983, the sexes have had statistically indistinguishable shapes of their quadratic-Gompertz mortality curves. Female lung cancer mortality patterns have shown a transformation from a nonsmoking to a smoking pattern. The modal age of the quadratic-Gompertzian lung cancer death rates has potential application in countries at earlier stages of the global tobacco epidemic. Where the modal age is falling (year-on-year), we can infer that the local lung cancer epidemic is getting worse, and where it is rising, that it has begun to abate.

Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970–2007

Smoking is a major contributor to all-cause mortality in Europe and accounts for one-fifth of the cancer-related deaths. Monitoring the tobacco epidemic via an analysis of lung cancer trends is essential in helping countries arrest the effects of tobacco epidemic in the region. The study aims to provide a comprehensive and up-to-date overview of the temporal patterns of lung cancer mortality in Europe, emphasizing country- and sex-specific differences. National lung cancer mortality data were extracted from the WHO mortality databank by age, sex, year of death (1970-2007) for 36 countries in Europe. Trends in lung cancer mortality in men have tended to decrease in many European countries during the last two decades, particularly in North and Western Europe. Among women, mortality rates are still increasing in many countries, although in a few populations, rates are beginning to stabilize, notably in the high-risk countries within Eastern Europe (Hungary, Poland and the Czech Republic), and in Northern Europe (Denmark, Iceland and the United Kingdom). Men and women are clearly in very different phases of the smoking epidemic, and, as reflected in the mortality rates by birth cohort, the stage varies widely by country within each European region. That lung cancer mortality trends in men are on a downwards path in most European countries while female rates continue to rise, points to an urgent need for national and European prevention strategies that target tobacco cessation and prevention among European women.

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.

Mortality From Lung Cancer and Tobacco Smoking in Ohio (U.S.): Will Increasing Smoking Prevalence Reverse Current Decreases in Mortality?

Despite significant changes in smoking patterns within the past few decades, lung cancer remains a major cause of cancer deaths in many developed countries in people of each sex, and one of the most important public health issues. The study aims to analyze the possible impact of changes in tobacco smoking practices in the state of Ohio (U.S.) on current and future trends and patterns of lung cancer mortality. Mortality rates from lung cancer were calculated for the period 1970 to 2001 on the basis of data from the National Center for Health Statistics. The Joinpoint regression approach was used to evaluate changes in time trends by sex, age, and race. Data on smoking prevalence in Ohio were retrieved from the Centers for Disease Control and Prevention website. Lung cancer mortality rates in Ohio have declined among men of all ages as well as in specific age groups in the 1990s, and the rate of increase among middle-aged and elderly women has dropped over time. The mortality rate among young women (ages 20-44) began to increase during the early 1990s. The prevalence of smoking in Ohio has increased since the early 1990s, especially among young persons. Recent trends in tobacco smoking in Ohio indicate that the declining trends in lung cancer mortality might be reversed in the future. An early indicator of possible change is the recent increase in mortality among young women. Implementation of the Ohio Comprehensive Tobacco Use Prevention Strategic Plan might help to disseminate proven prevention strategies among the inhabitants of Ohio and might thus prevent future increases in lung cancer mortality rates in the state.

Mortality experience of male workers at a UK tin smelter

Between 1937 and 1991, Capper Pass and Sons Limited operated a tin smelter complex in North Humberside, UK, at which employees were potentially exposed to a number of substances, including lead, arsenic, cadmium and natural series radionuclides. Decommissioning and site clearance continued until 1995. Between 1967 and 1995 the company was a subsidiary of Rio Tinto plc. The aim was to identify any significant excess, or deficits, in mortality among former employees that might be attributable to factors associated with occupation. We defined a cohort of 1462 males who had been employed for at least 12 months between 1/11/1967 and 28/7/1995, followed-up through to 31/12/2001. The mortality of the cohort was compared against that expected for both national and regional populations. Mortality from all causes and all cancers did not differ from that expected. Mortality from ischaemic heart disease showed a deficit and mortality from lung cancer showed a statistically significant excess. Mortality from smoking related diseases other than lung cancer showed a non-significant deficit. The pattern of lung cancer mortality is consistent with the hypothesis that the risk of lung cancer has been enhanced by occupational exposure to one or more carcinogens, the effect of which diminishes with time since exposure. The deficit in ischaemic heart disease may be attributed to a protective effect from manual labour. The results provide no evidence for attribution of other excess or deficits in mortality to factors associated with employment.

Patterns of lung cancer mortality in 23 countries: Application of the Age-Period-Cohort model

BackgroundSmoking habits do not seem to be the main explanation of the epidemiological characteristics of female lung cancer mortality in Asian countries. However, Asian countries are often excluded from studies of geographical differences in trends for lung cancer mortality. We thus examined lung cancer trends from 1971 to 1995 among men and women for 23 countries, including four in Asia.MethodsInternational and national data were used to analyze lung cancer mortality from 1971 to 1995 in both sexes. Age-standardized mortality rates (ASMR) were analyzed in five consecutive five-year periods and for each five-year age group in the age range 30 to 79. The age-period-cohort (APC) model was used to estimate the period effect (adjusted for age and cohort effects) for mortality from lung cancer.ResultsThe sex ratio of the ASMR for lung cancer was lower in Asian countries, while the sex ratio of smoking prevalence was higher in Asian countries. The mean values of the sex ratio of the ASMR from lung cancer in Taiwan, Hong Kong, Singapore, and Japan for the five 5-year period were 2.10, 2.39, 3.07, and 3.55, respectively. These values not only remained quite constant over each five-year period, but were also lower than seen in the western countries. The period effect, for lung cancer mortality as derived for the 23 countries from the APC model, could be classified into seven patterns.ConclusionPeriod effects for both men and women in 23 countries, as derived using the APC model, could be classified into seven patterns. Four Asian countries have a relatively low sex ratio in lung cancer mortality and a relatively high sex ratio in smoking prevalence. Factors other than smoking might be important, especially for women in Asian countries.

The pattern of lung cancer mortality in Montenegro.

The aim of the study was to examine recent lung cancer mortality trends in Montenegro in the period 1976-2000, with special emphasis on correlation with tobacco consumption. A population-based study analysing lung cancer mortality in Montenegro in the period 1976-2000 was carried out. Mortality rates were adjusted by direct method. A cohort analysis of age-specific death rates was performed. The analysis of tobacco consumption (cigarettes consumption per capita) was based on the official data for the period 1965-1990. Linear regression coefficients in a time trends analysis of mortality rates and tobacco consumption were assessed using Fisher's test. The highest average standardized lung cancer mortality rates in Montenegro increased in each successive five-year period for both sexes from 1976 to 2000, with highest values in the last five years (1996-2000). In males the death rate has almost doubled, and in females it was nearly three-fold higher. In the cohort analysis of age-specific death rates, all age groups in the birth cohort born before 1911 had a higher lung cancer mortality risk than those in the birth cohort comprising those born between 1912 and 1931. The rates showed an increasing tendency in all age groups irrespective of sex, except in males in the 25-44 age group. The time analysis of lung cancer mortality rates for the period 1976-2000, revealed annual changes of 3% for males and 6.6% for females, respectively. During the period observed the consumption of cigarettes increased by 98.2% (from 1.064 kg per capita in 1965 to 2.109 kg per capita in 1990). The significant increasing tendency in cigarette consumption was registered (y=1.10+0.05x, P=0.001). A significant correlation between lung cancer mortality rates and cigarette consumption is also observed (r=0.427, P=0.037). Smoking trends up to the 1990s in Montenegro, indicate that one can expect lung cancer mortality rates to continue to increase in males but even more so in females.

Recent trends and future directions for lung cancer mortality in Europe.

Lung cancer mortality patterns throughout Europe are very heterogeneous and largely reflect past smoking habits. In order to clarify the changing patterns of lung cancer in Europe we have plotted the overall lung cancer trends among men and women for 20 countries from 1950 up to1998. Furthermore, using a Bayesian age-period-cohort approach, we have calculated 5 year projections of lung cancer rate up to 2003. Finally, we make some comments on probable future trends by analysing recent trends in adults aged <55 years. Lung cancer mortality rates up to age 75 years portray a general trend of decreasing lung cancer rates among men and increasing lung cancer rates among women. Exceptions to this decrease among men include Hungary where not only are current mortality rates much higher than previously observed in any other country (at 76.7 out of 100 000 in 1998) but they are projected to increase further in the short term. Rates among adults aged <55 years have recently peaked, indicating that overall rates are likely to peak in the next decade. Among women, rapid increases have been observed in Denmark, Netherlands, Hungary, Ireland and UK. Whereas Ireland and UK rates have started to decrease and are projected to continue falling, rates in the other three countries are projected to increase further. Trends in women aged <55 years indicate that rates in Danish women will peak in the next decade, whereas lung cancer rates among Dutch women are likely to continue increasing. Rates in Hungarian women are likely to increase and will surpass the current high rate observed in Denmark.British Journal of Cancer (2002) 87, 43–48. doi:10.1038/sj.bjc.6600352 www.bjcancer.com© 2002 Cancer Research UK

Recent trends in lung cancer mortality in the United States.

Previous age-period-cohort analyses of lung cancer incidence and mortality rates in the United States have demonstrated a decrease in risk by birth cohort through 1950, consistent with declining trends in smoking prevalence. This study was conducted to examine recent lung cancer trends, including trends among the cohorts born after 1950. Lung cancer mortality rates from 1970 through 1997 for whites aged 24--83 years and for blacks aged 30--83 years were investigated. Using age--period--cohort analyses with 2-year age and 2-year calendar-period intervals, we examined changes in the slope of the trends in birth-cohort and calendar-period effects. All statistical tests are two-sided. There was an unexpected, statistically significant moderation in the rate of decrease of the birth-cohort trend in lung cancer mortality for whites born after 1950, with a corresponding smaller and statistically nonsignificant moderation for blacks. These data are consistent with smoking initiation rates: Rates of both cigarette and marijuana smoking initiation increased for children aged 12--17 years from 1965 through 1977. There was a statistically significant decrease in the slope of the calendar-period trend for lung cancer mortality in 1990 for both whites and blacks that was observed primarily in people 55 years of age and older. The birth-cohort pattern of lung cancer mortality after 1950 appears to reflect the early impact of teenage cigarette smoking on lung cancer risk in people under the age of 45 years, although a contribution from marijuana smoking cannot be ruled out. This result provides additional support for increasing smoking cessation and prevention programs for teenagers. The calendar-period decrease in lung cancer mortality after 1990 may reflect the long-term benefits of reductions in tobacco carcinogens in cigarettes and increases in smoking cessation beginning around 1960.