Trends in lung cancer mortality rates between 1979 and 2006 in Belgian and European men and women

Katrien Vanthomme, Vrije Universiteit Brussel
Paulien Hagedoorn, Vrije Universiteit Brussel

Introduction Lung cancer is the leading cause of cancer death in men and the second in women. However, female lung cancer mortality is rapidly increasing and may soon replace breast cancer as a leading cause. This paper focuses on Belgium, which makes an interesting case study as it has the highest lung cancer mortality within Europe. This study aims to map out and compare Belgian and European lung cancer mortality trends for both sexes between 1979 and 2006, and to relate these to smoking trends. Data and methods Mortality and population data were obtained from the World Health Organization Mortality Database. Smoking prevalence data were extracted from the European Health for All Database. Age-standardized mortality rates (ASMRs) were calculated by direct standardization using the European Standard Population. Results In Belgian men, the lung cancer ASMR declined from 177 to 123/100,000 over the study period. In Northern and Western Europe, the same trend was observed, while in Eastern and Southern Europe mortality was stable. Belgian male lung cancer mortality remains much higher than the Western European average. For Belgian women, the ASMR increased from 14 to 26/100,000 over the study period. Female lung cancer mortality increased in Western Europe unlike the other European regions. Overall, smoking rates were declining, yet slower and later in women. Discussion and conclusion Lung cancer remains the leading cause of male cancer death. Present lung cancer mortality is related to smoking levels of three to four decades ago. Hence, increasing female lung cancer mortality is a consequence of female smoking initiation in the 1960s. Belgium has gone through all smoking epidemic phases, as reflected by the declining lung cancer mortality among men. However, the increase in female lung cancer mortality is likely to continue, due to slower declines in female smoking. Therefore tobacco control remains crucial.