title: The oral cancer epidemic in central and eastern Europe.
abstract: To monitor recent trends in oral and pharyngeal cancer mortality in 38 European countries, we analyzed data provided by the World Health Organization over the period 1975-2004. Joinpoint analysis was used to identify significant changes in trends. In the European Union (EU), male mortality rates rose by 2.1% per year between 1975 and 1984, by 1.0% between 1984 and 1993, and declined by 1.3% between 1993 and 2004, to reach an overall age-standardized rate of 6.1/100,000 in 2000-2004. Mortality rates were much lower in women, and the rate in the EU rose by 0.9% per year up to 2000, and levelled off to 1.1/100,000 in 2000-2004. In France and Italy-which had the highest rates in the past-male rates have steadily declined during the last two decades (annual percent change, APC = -4.8% in 1998-2004 in France and -2.6% in 1986-2003 in Italy). Persisting rises were, however, observed in several central and eastern European countries, with exceedingly high rates in Hungary (21.1/100,000; APC = 6.9% in 1975-1993 and 1.4% in 1993-2004) and Slovakia (16.9/100,000; APC = 0.14% in 1992-2004). In middle aged (35 to 64) men, oral and pharyngeal cancer mortality rates in Hungary (55.3/100,000) and Slovakia (40.8/100,000) were comparable to lung cancer rates in several major European countries. The highest rates for women were in Hungary (3.3/100,000; APC = 4.7% in 1975-2004) and Denmark (1.6/100,000; APC = 1.3% in 1975-2001). Oral and pharyngeal cancer mortality essentially reflects the different patterns in tobacco smoking and alcohol drinking, including drinking patterns and type of alcohol in central Europe.
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. werner.garavello@unimib.it
authors.forename: Werner
authors.initials: W
authors.lastname: Garavello
authors.forename: Paola
authors.initials: P
authors.lastname: Bertuccio
authors.forename: Fabio
authors.initials: F
authors.lastname: Levi
authors.forename: Franca
authors.initials: F
authors.lastname: Lucchini
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Malvezzi
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*