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Updated: May 28, 2025

Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Time trend and age-period-cohort effect on kidney cancer mortality in Spain, 1983-2022
L Cayuela1, R Roldán Testillano2, S Cabrera Fernández3
1Servicio de Medicina Interna, Hospital Universitario Severo Ochoa, Leganés, Spain.
Objective:
This study examines trends and disparities in kidney cancer (KC) mortality in Spain from 1983 to 2022, focusing on gender, birth cohort, and age influences.
Methods:
Data from the Spanish National Institute of Statistics were analyzed using age-standardized mortality rates (ASMRs). Joinpoint regression identified temporal trends and annual percentage changes, while Age-Period-Cohort (A-P-C) analysis assessed the impacts of age, calendar period, and birth cohort on mortality.
Results:
KC mortality increased significantly for both sexes, with men experiencing a steeper rise (1.2% annually) compared to women (0.6% annually). Joinpoint analysis revealed distinct phases: a sharp increase until the mid-1990s, followed by stabilization for men and a slight decline for women. Men aged over 50, particularly those above 80, showed pronounced increases. A-P-C analysis confirmed age as a significant risk factor, with consistently higher mortality rates observed among men across all age groups. Men born from the early 20th century until the 1960s faced increasing mortality risks, while women's risk, after an increase in the early 20th century, stabilized after the 1933 birth cohort. For those born after 1960, both sexes show a potential decline in KC mortality, with a slight upturn in men from the 1980s onwards. The period effect exhibited an increase during the 1980s-1990s, followed by stabilization for men and a continuous decrease for women.
Conclusion:
This study reveals significant disparities in KC mortality trends in Spain across genders, birth cohorts, and age groups. Despite advancements in diagnosis and treatment, substantial public health challenges remain.
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