Wednesday February 9 2011
Lung cancer deaths in women will continue to increase in most EU countries
“Smoking to get slim puts UK women at top of Europe's lung cancer table”, reported the Daily Mail. The BBC and Independent covered the same story but with a different focus, saying that cancer deaths in Europe are “tipped to fall in 2011” and that lung cancer rates “may have peaked” in women.
These predictions are from a well-conducted study, based on the most recent data showing trends in cancer deaths. Researchers said that overall cancer rates are falling in Europe, but lung cancer rates among women are increasing. In the UK, despite levelling off, lung cancer deaths among women are still the highest in Europe.
These findings are estimates only, but are likely to be accurate. The Daily Mail’s claim that women’s lung cancer rates have risen because they took up smoking to control their weight is not supported by this research. As the researchers point out, their estimates may have limitations and, because they were based on the most recent available data up to 2007, are not likely to have picked up any change or reversal in trends in cancer deaths in the last two or three years.
Where did the story come from?
The study was carried out by researchers from the University of Milan, the National Tumour Institute, Milan, the Universitaire Vaudois and the University of Lausanne, both in Switzerland. It was funded by the Swiss Cancer league and the Italian Association for Cancer Research. The study was published in the peer-reviewed medical journal Annals of Oncology.
The study was reported accurately in the newspapers, with different papers focussing on different aspects of the story. The Independent’s headline said that lung cancer in women may have peaked in the UK, while the Mail’s headline pointed out that UK women are still at the top of the European lung cancer table. Both papers mention that historically women took up smoking later than men, which explains why male death rates peaked some 20 years ago.
What kind of research was this?
This study was based on a new mathematical model for predicting overall cancer mortality in the European Union, and individual rates in its six most populated countries. To build their projections, researchers used World Health Organization (WHO) mortality and population data, up to the most recently available years (2005-2007). The authors say that estimates of current cancer mortality are essential for planning to allocate resources and to design cancer-prevention strategies. However, mortality figures usually only become available after a few years. They say a reliable system has been developed to estimate current mortality rates in the USA, and they wanted to apply this method to European data.
What did the research involve?
Researchers obtained, from the WHO database, official data on deaths from all cancers for all 27 member states of the EU (as defined in January 2007) in the period 1970-2007 and up to the most recently available year for six countries: France, Germany, Italy, Poland, Spain and the UK. They also took population estimates from the same database, as well as projected estimates for the year 2011 from a European Commission database. They used this information to build a mathematical model that calculated the rates of cancer deaths each year and to identify trends, which they then used to predict death rates for 2011.
They looked at overall death rates for the 27 member states of the EU and individual rates in the six major EU countries specified.
What were the basic results?
The researchers predicted that there will be 1,281,436 cancer deaths in the EU in 2011 (721,252 men and 560,184 women). This represents a cancer death rate of 142.8 per 100,000 men and 85.3 per 100,000 women, a decrease of 7% and 6% respectively since 2007.
They say that mortality will continue to decline for most major cancers, including stomach, bowel, breast, uterus, prostate and leukaemia, as well as male lung cancer.
Female lung cancer mortality rates will continue to increase in all major EU countries except the UK, where they seem to be levelling off. In the UK, the death rate is predicted to be 20.33 per 100,000 women, a very slight drop from 20.57 per 100,000 in 2007 and three times higher than in Spain (6.5 per 100,000). Lung cancer is the biggest cause of cancer death among women in the UK and Poland.
The researchers also found that:
- The death rates for pancreatic cancer in women that were observed up to 2004 will probably level off.
- Poland has the highest cancer mortality rates and will also have the smallest decline in rates.
- France is also predicted to have only a “modest decline” in cancer rates.
- Germany will have the greatest reduction in cancer deaths.
How did the researchers interpret the results?
The researchers say that the decline in mortality for most major cancers over recent years is likely to continue in 2011 in all six EU countries studied and probably other EU countries too.
They also point out that lung cancer mortality in women is steadily increasing, apart from in the UK where rates were already high a decade ago. Lung cancer has become the biggest cause of cancer death among women both in the UK and Poland.
Pancreatic cancer has shown a worrying upward trend in the past, especially among women, but this is likely to level off. This rise in pancreatic cancer may be partly due to the increased prevalence of obesity and diabetes.
The researchers also point out that across Europe, the number of deaths (called the absolute number) remains the same, due to the ageing of the population.
Finally, they say that despite favourable trends across Europe, the higher cancer mortality in countries in central and Eastern Europe, such as Poland, is likely to persist in the future.
These predictions come from a well-conducted study, which used the most recent data on cancer mortality trends. While the findings are estimates, they’re likely to be accurate. Overall, cancer rates in Europe are falling, but lung cancer rates among women are rising. In the UK, despite levelling off, lung cancer mortality among women is still the highest in Europe. The Daily Mail’s claim that the rise in women’s lung cancer rates is because they took up smoking to control their weight is not supported by this research.
It should be noted that the study is mostly based on data up to 2007, and even earlier in the case of some countries. Therefore, more recent changes or reversals in mortality trends in the last two or three years would not have been picked up.