title: Contribution of changes in demography and in the risk factors to the predicted pattern of cancer mortality among Spanish women by 2022.
abstract: BACKGROUND
  Changes in the burden of cancer mortality are expected to be observed among Spanish women. We predict those changes, in Spain, for breast cancer (BC), colorectal cancer (CRC), lung cancer (LC) and pancreatic cancer (PC) from 2013 to 2022.
  
  
  METHODS
  Bayesian age-period-cohort modeling was used to perform projections of the cancer burden in 2013-2022, extrapolating the trend of cancer mortality data from 1998 to 2012. We assessed the time trends of the crude rates (CRs) during 1998-2012, and compared the number of cancer deaths between the periods 2008-2012 and 2018-2022 to assess the contribution of demographic changes and changes in the risk factors for cancer.
  
  
  RESULTS
  During 1998-2012, CRs of cancer decreased for BC (0.3% per year) and increased for LC (4.7%), PC (2%) and CRC (0.7%). During 2013-2022, CRs might level off for CRC, whereas the time trends for the remaining cancers might continue at a similar pace. During 2018-2022, BC could be surpassed by CRC as the most frequent cause of cancer mortality among Spanish women, whereas LC could be the most common cause of cancer mortality among women aged 50-69 years (N/year=1960 for BC versus N/year=1981 for LC). Comparing 2018-2022 and 1998-2012, changes in the risk factors for cancer could contribute 37.93% and 18.36% to the burden of LC and PC, respectively, and demographic shifts - mainly due to ageing (19.27%) - will drive the burden of CRC.
  
  
  CONCLUSIONS
  During 2018-2022, demographic changes (ageing) and changes in risk factors could have a different impact on the lifetime risk of cancer among Spanish women.
authors.affiliation: Catalan Institute of Oncology-Plan for Oncology of the Catalan Government, IDIBELL, Av Gran Via 199-203, 08908 Hospitalet de Llobregat, Catalonia, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona 08907, Spain. Electronic address: r.cleries@iconcologia.net.
authors.forename: Ramon
authors.initials: R
authors.lastname: Clèries
authors.affiliation: Biomedical Research Institute (IdIBGi), Girona 17005, Spain; Computer Science, Applied Mathematics and Statistics Department of the University of Girona (UdG), Girona 17041, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Buxó
authors.affiliation: Servicio de Investigación y Análisis IT-EP, MC Mutual, Carrer de Provença, 344, Barcelona 08037, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez
authors.affiliation: Catalan Institute of Oncology-Plan for Oncology of the Catalan Government, IDIBELL, Av Gran Via 199-203, 08908 Hospitalet de Llobregat, Catalonia, Spain.
authors.forename: Josep A
authors.initials: JA
authors.lastname: Espinàs
authors.affiliation: European Commission, DG Joint Research Centre, Institute for Health and Consumer Protection, Public Health-Cancer Policy Support, 21020 Ispra (Varese), Italy.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dyba
authors.affiliation: Catalan Institute of Oncology-Plan for Oncology of the Catalan Government, IDIBELL, Av Gran Via 199-203, 08908 Hospitalet de Llobregat, Catalonia, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona 08907, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Borràs
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D001943:Breast Neoplasms / Q000209:etiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000209:etiology / Q000401:mortality*; D003710:Demography; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D055815:Young Adult
keywords: Ageing; Cancer mortality; Demographic changes; Projections; Risk of death