Abstract
BACKGROUND: Lung cancer is the leading cause of cancer deaths worldwide, with considerable geographical variation. In the Czech Republic, the male population experienced the highest lung cancer mortality rates in the mid-80s, ranking with the top mortality rates in Europe.
Since that time, notable changes in time trends, widely different for men and women, were observed. The objective of the work is to analyze the trends in lung cancer mortality in the Czech Republic over the last 45 years, to estimate the prediction of the trends for the next decade, and consider the results of some recent surveys informing on the smoking patterns of the Czech population.
METHODS AND RESULTS: Standardized mortality from lung cancer in Czech men increased from 22.3/100,000 in 1950 to 79.8 in 1986, and decreased to 69.7 in 1995 (world standard). In the female population: 4.3/100,000 in 1950, 8.5 in 1986, and 11.6 in 1995, respectively.
Using a log-linear Poisson regression model, a decrease to 68.0/100,000 for men, and an increase to 16.1 for women by the end of the next decade has been predicted. Some decreases in the age-specific lung cancer mortality rates were observed in young adult men, and, for the next decade, similar trends have been predicted for middle-aged men.
In the female population, the trends have been rising in all age groups. There was an increase in the cigarette consumption in the Czech Republic from 1731 cigarettes per 1 inhabitant aged 15 years and older in 1953 to 2552 cigarettes in 1978, and a subsequent decrease to 2279 cigarettes in 1989.
The prevalence of smoking in six Czech districts participating in the MONICA project (25) had a downward trend in men aged 25-64 years during the period 1985-1992, whereas no significant changes in smoking prevalence were observed for women. CONCLUSIONS: In the recent phase of the lung cancer epidemic in the Czech Republic, a turn for the better has been taken in men: a decreasing trend in standardized lung cancer mortality was observed since the late 1980s, and its continuation up to 2009 has been predicted (on the average, by -0.7% annually).
Conversely, in the female population, further increases in lung cancer mortality can be expected for the next decade (by 3.1% annually). Consequently, a comprehensive control of smoking in women appears to be a priority in lung cancer prevention.
Moreover, further studies in the role of potential cofactors affecting the incidence of lung cancer in women deserve attention.