Cigarette smoking and lung cancer trends in Serbia--a ten-year analysis

Cigarette smoking is the single most common cause of morbidity and mortality in the world, and the most important risk factor for developing lung cancer (LC). LC is the most frequent form of cancer in men worldwide. Almost half of the adult population in Serbia smokes. The aim of the study was to analyze the incidence rate (IR) and trend of LC in Serbia from 1994 to 2003, with special regard to tobacco smoking status (TSS). Referral annual reports of the Institute of Lung Diseases and Tuberculosis on newly diagnosed cases of LC, categorized by sex and TSS, have been analyzed TSS included three categories: smokers, ex-smokers and non-smokers. LC IR showed an increasing tendency (RR: 0.2859) with 34/100,000 population in 2003, and significant differences among districts (6.3-39.1/100.000). Smokers, ex-smokers, and non-smokers account for 70.3%, 17% and 12.6%, respectively (p < 0.001). An increasing trend of female lung cancer was evident in all three categories, but the most remarkable in smokers. There is a clear and urgent need to inform the population on harmful effects of tobacco smoking on health and risks for lung cancer.