Lung cancer mortality patterns in selected Central, Eastern and Southern European countries

Abstract

Significant changes in the prevalence of tobacco smoking have been observed in many European countries. EU candidate countries have also experienced major changes with respect to tobacco smoking, which have resulted in changes in the frequency of lung cancer. In men in the majority of these countries, a reduction of mortality rates has been observed recently, while in Hungary and Poland a deceleration of mortality increase was observed in the 1990s. The situation is much less favorable in females, where in the majority of countries a continuous increase of mortality rates has been observed, the only exceptions being Latvia, Lithuania and, to a lesser extent, Estonia. In Hungarian women, an acceleration of the increase rate was observed in the 1980s and 1990s (compared with the 1970s). Patterns of lung cancer mortality in analyzed countries are somewhat similar to those observed in EU member states. Recent analyses of time trends of lung cancer in EU countries showed, in general, a decreasing risk in the majority of male populations and an increase in several countries in women. If the decrease of mortality is to be achieved and maintained in the longer term, efforts have to be focused on young generations (entering adulthood now or in the near future). Despite all the difficulties present in reducing tobacco smoking in youth, it seems that one of the most important ways to reduce the future lung cancer burden in current and new EU member states is to strengthen efforts toward changing smoking attitudes in young generations. © 2004 Wiley-Liss, Inc. Key words: lung cancer; mortality; trends; European Union; regressionLung cancer has been a major public health issue in Europe for many years. This disease is the most frequent cause of cancer deaths in males in the majority of European countries and one of the most frequent in females. Although several studies have dealt with time trends of lung cancer in the European Union member states, relatively little has been published on lung cancer time trends in other parts of the continent. [1][2][3][4][5][6] This article aims to analyze and discuss recent changes in mortality trends in countries that are candidates for membership of the European Union.It is well known that the major risk factor for lung cancer is tobacco smoking, and that there is a relationship between the magnitude of the risk and duration and intensity of smoking, age of initiation, type of cigarettes smoked and time since smoking cessation. 7-12 All these factors influence changes in the frequency and incidence of and mortality from lung cancer in the given population.In many West European countries, decreasing trends in the prevalence of tobacco smoking in men observed since the 1960s and 1970s caused a decline in lung cancer mortality 1-2 decades later. In contrast, in many countries, increase of smoking prevalence in women caused an increase in mortality from lung cancer.Similar changes in smoking patterns were observed in the 1980s and 1990s in the majority of the EU accession countries. It implies...

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