Epidemiology of cancer mortality.
The level in each sex of site-specific cancers mortality is highly variable among 40 countries worldwide and somewhat less in the EU. The mortality ratio of the country worldwide with the highest upon that of the lowest cancer rate varied from 6 to 24 times in men and 6 to 17 times in women. In the EU it ranked from 3 to 10 in men and from 2 to 9 in women. Total cancer mortality had a smaller ratio (2 to 4) suggesting external and/or internal feedback mechanisms. The changes in site-specific cancer mortality rates worldwide over the years are also markedly different. A decreasing pattern since 1980 is more frequent in stomach and rectum cancer rates in each sex, in male lung cancer and in endometrium cancer. An increasing pattern is more often seen in prostate cancer, breast cancer, female lung cancer and male colon cancer. The most significant positive correlations of cardiovascular diseases are observed with rectum cancer in each sex and with endometrium cancer. Only male lung cancer correlates significantly with cardiovascular diseases. Prostate, breast and colon cancer are not positively and significantly related to cardiovascular diseases. The comparison of cancer mortality data from Belgium, The Netherlands and Denmark between 1955 and 1993 are consistent with previous results. The reliability of cancer mortality data and the role of genetic and environmental factors are discussed in two addenda. Finally it can be concluded that colon and rectum cancer behave differently at the population level. Colorectal cancer mortality data will provide misleading epidemiological results.
Joossens
J V
JV
Faculteit Geneeskunde Departement School voor Maatschappelijke Gezondheidszorg Afdeling Epidemiologie Kapucijnenvoer 35, B-3000 Leuven.
Kesteloot
H
H
D017677:Age Distribution; D000368:Aged; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D017678:Sex Distribution