title: Age- and Sex-Specific Trends in Lung Cancer Mortality over 62 Years in a Nation with a Low Effort in Cancer Prevention.
abstract: BACKGROUND
  A decrease in lung cancer mortality among females below 50 years of age has been reported for countries with significant tobacco control efforts. The aim of this study was to describe the lung cancer deaths, including the mortality rates and proportions among total deaths, for females and males by age at death in a country with a high smoking prevalence (Germany) over a time period of 62 years.
  
  
  METHODS
  The vital statistics data were analyzed using a joinpoint regression analysis stratified by age and sex. An age-period-cohort analysis was used to estimate the potential effects of sex and school education on mortality.
  
  
  RESULTS
  After an increase, lung cancer mortality among women aged 35-44 years remained stable from 1989 to 2009 and decreased by 10.8% per year from 2009 to 2013.
  
  
  CONCLUSIONS
  Lung cancer mortality among females aged 35-44 years has decreased. The potential reasons include an increase in the number of never smokers, following significant increases in school education since 1950, particularly among females.
authors.affiliation: Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald D-17489, Germany. ujohn@uni-greifswald.de.|German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Berlin D-13347, Germany. ujohn@uni-greifswald.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.affiliation: Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald D-17489, Germany. hanke@uni-greifswald.de.
authors.forename: Monika
authors.initials: M
authors.lastname: Hanke
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012737:Sex Factors; D012907:Smoking
keywords: death age; education; female; lung cancer mortality; vital statistics