Prediction of lung cancer mortality in four Central European countries, 1990-2009

During the post-war decades the cancer mortality in Europe has undergone deep changes. In the 1980s, remarkable increases in lung cancer mortality in the Central and Eastern European area resulted in rates equaling or exceeding those in most Western countries. In the present work, the future development of the lung cancer epidemic has been assessed in four Central European countries (Austria, Czech Republic, Hungary, and Slovakia) for the period 1900-2009, taking into consideration previously observed lung cancer mortality trends (1960-1989), in the same countries. The estimation of the predicted mortality trends was based on log-linear Poisson regression age/period/cohort model, using GLIM for calculation. In the twenty-year period from 1985-1989 to 2005-2009, the age-adjusted (world standard) lung cancer mortality rates for men are predicted to increase in Hungary and Slovakia, and show little change in Austria and the Czech Republic. For women, approximately exponential increases in lung cancer mortality rates (both adjusted all-age, and age-specific at young adult ages up to 44 years) can be expected, with highest rates in Hungary, intermediate in the Czech Republic and Austria, and lowest in Slovakia. Lung cancer mortality in women is still much smaller than in men, however, rapidly increasing, with less variation in trends between countries than in men. The current and predicted high and/or increasing lung cancer mortality rates in the countries under study, presumed to be associated with elevated exposure to respiratory carcinogens, mainly cigarette smoke, in previous decades, underlines that the control of smoking continues to be a priority among approaches to cancer prevention.