Trends in lung cancer mortality in Portugal (1955-2005); [Evolução da mortalidade por cancro do pulmão em Portugal (1955-2005)]

Abstract

Introduction: While the rate of smoking and lung cancer mortality has been decreasing in western Europe, there was no decline in lung cancer mortality in Portugal until 1998. Aim: To describe lung cancer mortality trends in Portugal. Methods: Lung cancer mortality rates (International Disease Classification 10: C33-34) in Portugal 1955-2005 by gender and 5-year age groupings were provided by the World Health Organization and the National Institute of Statistics. Standard mortality rates (direct method, world population) were calculated for the 35-74, 35-44, 45-54, 55-64 and 65-74 year-old age groups. Joinpoint regression was used to calculate the annual percent change (APC) in mortality and to identify any inflection points. Results: Between 1955 and 2005 we observed a stabilisation in lung cancer mortality in men aged 35-74 years old, varying 3.77%/year (95% confidence interval [95%CI]: 3.53-4.01) in 1955-1986 and -0.15%/year (95%CI: -0.99-0.69) in 1996-2005. We observed negative APC point estimates (with none significantly below zero) in the most recent trends except for the 45-54 age group, where we only noted an APC deceleration since 1981. The mortality increased 1.60%/year (95%CI: 1.40-1.77) in women aged 35-74 years old 1955-2005. Conclusion: In the last two decades we observed a lung cancer mortality stabilisation in males, whereas mortality in females increased continuously. These results place Portugal at the end of the third stage of the smoking epidemic.