Thursday April 24 2014
Cigarettes were marketed to women as slimming aids
"Lung cancer will soon become the biggest cancer killer among women," the Mail Online reports, while ITV News reveals that pancreatic cancer "poses [a] growing threat". Both headlines are prompted by a study that has estimated future cancer trends across the EU.
The researchers estimate there will be approximately 1.32 million deaths from the eight most common cancers in 2014. They predict that in women, deaths from breast and colorectal cancers will decrease, but lung cancer rates are expected to increase by 8%.
This increase had been linked to what has been termed the "Mad Men effect" – the fact that during the early 1960s, cigarettes were aggressively marketed towards women as an alleged slimming aid. Women who took up the habit then may be paying the price for it now.
The report also looked specifically at pancreatic cancer as previous reports have shown unfavourable trends for this type of cancer. Cancer of the pancreas is a very serious form of cancer that is both difficult to detect and treat.
Because pancreatic cancer causes few symptoms in its early stages, the condition is often not diagnosed until the cancer is relatively advanced.
People with advanced pancreatic cancer have an average life expectancy of around seven months. Pancreatic cancer is the only cancer predicted to increase in both men and women.
The main limitation of this type of study is that figures included in the report are best guesses, so figures and trends may not reflect actual figures that occur.
Where did the story come from?
The study was carried out by researchers from the University of Milan and the University Hospital of Lausanne. It was funded by the Swiss League against Cancer, the Swiss Cancer Research Foundation, and the Italian Association for Cancer Research.
The study was published in the peer-reviewed medical journal, Annals of Oncology.
The story was picked up by a number of UK media sources. The Mail Online and The Independent failed to inform the reader that the report provides estimates of deaths from cancers based on extrapolations of data from 2009. As such, the predictions are subject to assumptions made by the researchers.
ITV News and MSN News took a different tack, highlighting the potential growing threat of pancreatic cancers. As with lung cancer, rates of pancreatic cancers are based on extrapolated data. But if such a trend did occur, this would be worrying because of the current poor prognosis for this type of cancer.
What kind of research was this?
This was a modelling study based on official death certification data from various cancers. It aimed to predict the rates of deaths from cancer across Europe and six European countries for the year 2014.
This report is an update of previous estimates of deaths from cancers across Europe, which used similar methods. This type of study is therefore useful at looking at trends in these cancers over time as it can be compared to past reports.
However, the figures provided in this report are predictions, so they may not represent the amount of actual deaths from cancers that occur.
What did the research involve?
To predict deaths from cancers for the year 2014, researchers used official population and death certificate data obtained from the World Health Organization (WHO) and Eurostat for the following cancers:
- leukaemia (blood cell cancers)
They also estimated total deaths from cancers.
For the European Union, figures were used for the period 1970 to 2009. The most recently available data was used for the following six major European countries:
Based on the available data, the researchers predicted age-specific deaths from cancer from birth to over the age of 80 in five-year age groups.
Using statistical techniques, the predicted age-specific numbers of deaths and population data were then used to estimate the predicted death rates from cancer for 2014.
What were the basic results?
The main predictions from the report were:
- In the European Union, approximately 1.32 million deaths from cancer are predicted in 2014 (742,500 men and 581,100 women). The researchers say this resembles a death rate of 138.1 per 100,000 for men (indicating a decrease of 7% since 2009) and 84.7 per 100,000 for women (indicating a decrease of 5% since 2009).
- In women, breast and colorectal cancers are predicted to decrease (9% decrease for breast cancer and 7% decrease for colorectal cancer), but lung cancer rates are predicted to increase by 8%.
- In men, predicted rates of the three major cancers in 2014 are lower than in 2009 – lung (decrease of 8%), colorectum (decrease of 4%) and prostate (decrease of 10%).
- Pancreatic cancer is the only cancer predicted to increase in both men and women.
- Trends across the European Union for the 20-49 age group are predicted to become more favourable for men, but slight increases are predicted for women.
How did the researchers interpret the results?
The researchers conclude that cancer death predictions for 2014 confirm the overall favourable cancer death trend in the European Union, translating to an overall 26% reduction in men since its peak in 1988, and 20% in women.
It is predicted that more than 250,000 deaths will be avoided in 2014 compared with the peak rate. They say notable exceptions are for female lung cancer and pancreatic cancer in both sexes.
Lead researcher Professor Carlo La Vecchia, from the University of Milan, is quoted in the media as saying: "The increased death rate [for pancreatic cancer] is cause for concern because the prognosis for this tumour is bleak, with less than 5% of pancreatic cancer patients surviving for five years after diagnosis.
"As so few patients survive, the increase in deaths is very closely related to the increase in incidence of this disease. This makes pancreatic cancer a priority for finding better ways to prevent and control it, and better treatments."
In their discussion, the researchers say the total male cancer death rate is 63% higher than the female rate, but that the male rate is falling faster.
They indicate this difference is mainly because of the different smoking pattern history among men and women.
It is expected that lung cancer will become the main cause of cancer death for women in the next few years.
But the data gathered by the researchers is not unremittingly gloomy. They predict that deaths associated with cancers responsive to treatment – such as leukaemia, breast and prostate cancer – will continue to fall.
This is the result of a combination of improved early diagnosis and screening, as well as improved treatments and disease management.
This type of study provides useful estimates of possible deaths in 2014 from eight different types of cancers, including breast, lung and pancreatic cancer.
The study's strengths include that it used official data from the World Health Organization (WHO) and Eurostat. Similar methods from previous reports on this topic were also used so that comparisons could be made and trends predicted.
The main limitation of this type of study is that the figures included in the report are estimates based on data from 2009 of cancer deaths for 2014.
The predicted figures and trends may not reflect new disease management or treatment initiatives that have occurred since 2009 as they include extrapolations of the trends seen in previous data.
There may now be a case for shifting more resources into researching new methods of managing lung cancer in women and pancreatic cancer in both sexes.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.