“…Among men, a diminution in smoking prevalence, followed by a peak and decline in lung cancer rates in the same generations, was first observed in several high-income countries where smoking was first established, including the United Kingdom, the United States, Finland, Australia, New Zealand, the Netherlands, Singapore, and (more recently) Germany, Uruguay, and the remaining Nordic countries. 15,16 A recent analysis of incidence trends in 26 European countries revealed that rates in men aged 35 to 64 years have been decreasing in recent years, including Eastern European countries, although rates were still increasing in Bulgaria. 17 Among women, the epidemic is less advanced and, in contrast to men, most countries are still observing a rising trend in incidence, 17,18 and only a relatively few populations (eg, the United States [whites] and possibly the United Kingdom) are showing signs of a peak and decline among recent birth cohorts.…”