Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men

Abstract

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

Inequalities in esophageal cancer mortality in Brazil: Temporal trends and projections

“…The differences observed in esophageal cancer mortality for men and women, across Brazilian geographic regions, agree with other studies [ 50 , 40 – 44 ]. Men present higher incidence and mortality due to higher exposure to risk factors for this neoplasm [ 9 – 12 ], and because men utilize less health services, such as medical tests and appointments [ 50 ].…”

“…It was also observed, for both sexes and for all geographic regions, a progressive increase in mortality rates with the aging process, reaching an incidence peak in individuals in their 60's. These results corroborate those found in Korea [ 40 ], Osaka-Japan [ 41 ], Linzhou-China [ 42 ], Australia [ 43 ], Spain [ 44 ], Germany [ 27 ], Cuba [ 27 ] and the United Kingdom [ 27 ]. This was expected, as there is strong effect of age on the evolution of incidence and mortality rates of chronic diseases, which are a consequence of exposure to risk factors throughout life [ 14 – 15 ].…”

“…In this study, the progressive reduction in esophageal cancer death risk for birth cohorts after the 1950's is remarkable for Brazil, the South, Southeast and North regions, for both sexes, and after the 1960's for the Midwest region. This decrease in death risk can be a consequence of the birth cohort effect promoted by the reduction of tobacco consumption prevalence in these populations [ 40 – 44 ]. This hypothesis is reinforced because there has been a decrease in death risk, in Brazil, for esophageal [ 21 ] and lung [ 52 ] cancers starting with the same cohorts.…”

Incidence and survival of oropharyngeal cancer in Denmark: a nation-wide, population-based study from 1980 to 2014

“…The war might have resulted in a less promiscuous lifestyle among these cohorts, simply because the curfews and obligatory blackouts resulted in less opportunity to meet new sex partners and in a more restricted lifestyle in general. A Korean study showed a similar cohort effect and attributed this to a change in smoking behavior [24]. This cause could also be the case in Denmark as the supply of tobacco was limited during the war.…”

Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database

“…18,19 Prevalence of cigarette smoking, especially among men, has dramatically decreased during the last few decades in Korea. 20 However, the prevalence of high-risk alcohol consumers has slightly increased in both men (19.9% to 20.8%) and women (3.4% to 5.8%) between 2005 and 2015, 21 and prevalence of insufficient consumption of non-salted vegetables and fruits did not change significantly between 1998 and 2012. 22 In addition, the prevalence of obesity gradually increased from 25.7% in 1998 to 35.1% in 2005 and 37.9% in 2013-2014 in men, when obesity was defined as having a body mass index of 25 kg/m 2 or higher; however, the prevalence of obesity in women decreased during The World standard population was used as standard population.…”