Age-period-cohort effect on lung cancer mortality in southern Spain.
The aim of this study was to evaluate the age-period-cohort effects on lung cancer mortality in Andalusia (southern Spain) as a whole as well as in each of its eight provinces during the period between 1981 and 2008. A population-based ecological study was conducted. In all, 74 255 deaths from lung cancer were analysed for individuals aged between 40 and 84 years who died in Andalusia during the period of study. A nonlinear regression model was estimated for both sexes and each geographical area. The effects of age, year of death and birth cohort were parameterized using B-spline smoothing functions. There is an upward trend in mortality by age until around the age of 75 years, from which point the trend turns downwards for men and remains stable for women. The analysis of the cohort effect revealed a steady fall in the lung cancer mortality risk for male generations born after 1950. The mortality risk for women is increasing for the generations born after 1932. The death rates for men declined from 1995 until the end of the study period. For women, the death rates increased from the end of the 1990s. There is a similar age-period-cohort effect on lung cancer mortality in all the provinces of Andalusia and for Andalusia as a whole. If the current trends continue, it can be expected that these effects will continue to reduce male mortality and increase female mortality.
aAndalusian School of Public Health bGranada Biomedical Research Institute, Granada cDepartment of Pharmacology, School of Medicine, University of Málaga, Málaga dDepartment of Epidemiology and Occupational Health, Andalusian Health Government, Seville, Spain.
Ricardo
R
Ocaña-Riola
José M
JM
Mayoral-Cortés
Encarnación
E
Blanco-Reina
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors