Trends in lung cancer mortality in Portugal (1955-2005).
BACKGROUND
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.


OBJECTIVE
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.


CONCLUSIONS
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.
Alves
Luís
L
Hygiene and Epidemiology Unit, Faculty of Medicine, Universidade do Porto, Porto, Portugal. lalves@med.up.pt
Bastos
Joana
J
Lunet
Nuno
N
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011174:Portugal / Q000453:epidemiology; D013997:Time Factors