Joinpoint regression analysis of lung cancer mortality, Andalusia 1975-2000.
BACKGROUND
Previous analyses of lung cancer mortality were based on models of death rates within one time period, assuming that rates increase or decrease with time at a constant rate. The aim of this work is to analyse recent changes in lung cancer mortality trends in Andalusia (Spain) during the period of 1975-2000 using joinpoint regression models.


METHODS
Mortality data were obtained from the Death Registry of Andalusia. For each gender, age group-specific and standardised (overall and truncated) rates were calculated by the direct method (using the world standard population). The joinpoint analysis was used to identify the best-fitting points where a statistically significant change in the trend occurred.


RESULTS
Lung cancer is the leading cause of cancer mortality in men, with an increasing trend up to 1994. After that year, rates began to decrease significantly (-1.8% yearly from 1994 to 2000). Standardised rates in women exhibited a downward trend until the early 1990s, after which they levelled off (overall standardised rates) or increased significantly (truncated rates 35-64 years).


CONCLUSIONS
An increase in lung cancer mortality has been observed in young women. There seems to be a relationship with the prevalence in smoking in men and women.
Cayuela
A
A
Research Department, Virgen del Rocío University Hospitals, Unided de Apoyo a la Investigación, Avenida de Manuel Siurot, s/n, 41013 Seville, Spain. aurelio.cayuela.sspa@juntadeandalucia.es
Rodríguez-Domínguez
S
S
López-Campos
J L
JL
Otero Candelera
R
R
Rodríguez Matutes
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016021:Epidemiologic Studies; D005260:Female; D049673:History, 20th Century; D006801:Humans; D008175:Lung Neoplasms / Q000266:history / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012042:Registries / Q000706:statistics & numerical data*; D012044:Regression Analysis; D013030:Spain / Q000453:epidemiology