title: Differences between Men and Women in Time Trends in Lung Cancer Mortality in Spain (1980-2013).
abstract: BACKGROUND
  The main risk factor for lung cancer is smoking, a habit that varies according to age and sex. The objective of this study was to explore trends in lung cancer mortality by sex and age from 1980 to 2013 in Spain.
  
  
  METHODS
  We used lung cancer mortality (International Classification of Diseases code 162 for the 9th edition, and codes C33 and C34 for 10th edition) and population data from the Spanish National Statistics Institute. Crude, truncated, age-adjusted mortality and age-specific mortality rates were assessed through joinpoint regression to estimate the annual percent change (APC).
  
  
  RESULTS
  Age-adjusted mortality rate significantly increased from 1980 to 1991 among men (APC=3.12%) and significantly decreased between 2001 and 2013 (APC=-1.53%), a similar pattern was observed in age-specific rates. Among women, age-adjusted mortality rate increased from 1989 (APC 1989-1997=1.82%), with the greatest increase observed from 1997 until the end of the study in 2013 (APC=4.41%).
  
  
  CONCLUSIONS
  Diverging trends in the prevalence of smoking could explain the increase in the rate of lung cancer-related mortality among Spanish women since the early 1990s. Public health policies should be implemented to reduce tobacco consumption in women and halt the increase in lung cancer mortality.
authors: Área de Bioestadística, Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
authors: Juan Carlos
authors: JC
authors: Martín-Sánchez
authors: Plan for Oncology of the Catalan Government, L'Hospitalet de Llobregat, Barcelona, España; Departamento de Ciencias Clínicas, Facultad de Medicina, Universitat de Barcelona, Barcelona, España.
authors: Ramon
authors: R
authors: Clèries
authors: Área de Bioestadística, Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
authors: Cristina
authors: C
authors: Lidón-Moyano
authors: Centre d'Atenció Primària Les Corts, Transverse Group for Research in Primary Care, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Área de Salud Pública, Departamento de Medicina, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
authors: Luis
authors: L
authors: González-de Paz
authors: Área de Bioestadística, Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, España; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España. Electronic address: jmmartinez@uic.es.
authors: Jose M
authors: JM
authors: Martínez-Sánchez
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015995:Prevalence; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D000073869:Tobacco Smoking; D055815:Young Adult
keywords: Cáncer de pulmón; Diferencias por sexo; Incidence; Incidencia; Lung cancer; Mortalidad; Mortality; Sex differences; Tabaco; Tobacco