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Worldwide lung cancer deaths among women to increase 40% by 2030
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The global lung cancer mortality rate among women is projected to increase 43% by 2030, whereas the breast cancer mortality rate is projected to decrease 9%, according to findings from an analysis of 52 countries.
These data suggest that, among high-income countries, lung cancer mortality rates are expected to surpass those of breast cancer by 2030.
“Our results are very important for current smoking women because there is a delay of around 30 to 40 years between the habit of smoking and the development of lung cancer. For this reason, we could break this trend, empowering and helping women to stop smoking,” Jose M. Martínez-Sánchez, PhD, MPH, BSc, associate professor and director of the department of public
health, epidemiology and biostatistics at Universitat Internacional de Catalunya in Spain, told HemOnc Today. “We have to raise awareness among the population, particularly women, about the health impact of smoking. Policymakers should implement comprehensive tobacco control measures, including help for smokers to quit, and for clinicians to promote clinical practices to quit smoking.”
Breast cancer has remained the leading cause of cancer mortality among women; however, breast cancer mortality rates have been decreasing, likely due to new therapies and the implementation of screening programs.
Conversely, smoking has increased among women in some countries.
“For this reason, we predict lung cancer mortality will surpass breast cancer mortality in the near future,” Martínez-Sánchez said.
Breast and lung cancer rates and mortality vary between countries based on the implementation of breast cancer screening programs and access to therapies, as well as rate of tobacco use.
Few studies have estimated trends in mortality caused by breast and lung cancers on a global scale.
Martínez-Sánchez and colleagues sought to estimate mortality rates for lung and breast cancer among women worldwide through 2030.
Researchers evaluated breast and lung cancer mortality data from the World Health Organization Mortality Database. The analysis included data from 52 countries — 29 from Europe, 14 from the Americas, seven from Asia and two from Oceania — that reported data between 2008 and 2014 and had a population greater than 1 million.
Investigators stratified deaths and population according to country, year and age. They calculated lung and breast cancer age-standardized mortality rates among women — reported per 100,000 person-years — for each country based on the WHO World Standard Population.
Using a Bayesian log-linear Poisson model, researchers projected age-standardized mortality rates for 2015, 2020, 2025 and 2030 using data obtained from the United Nations Population Division.
Results showed a median global mortality rate for lung cancer of 16 per 100,000 person-years in 2030 compared with 11.2 per 100,000 person-years in 2015. Oceania was the only country predicted to see a decrease in lung cancer mortality — from 17.8 in 2015 to 17.6 in 2030.
The overall median age-standardized mortality rate for breast cancer is projected to decrease from 16.1 in 2015 to 14.7 in 2030.
Researchers observed the highest age-standardized mortality rates for lung and breast cancers among high-income countries, for which lung cancer mortality rates will surpass breast cancer mortality by 2020. Researchers also observed the greatest decreases in breast cancer mortality in high-income countries.
Lung cancer mortality had surpassed breast cancer mortality by 2010 in 15 of the countries, and researchers predicted this trend would continue in another 11 countries by 2030. For the other 26 countries, lung cancer mortality is not expected to surpass that of breast cancer until after 2030.
Analyses projected Europe and Oceania to have the highest lung cancer mortality rates in 2030, and American and Asia to have the lowest.
Martínez-Sánchez cited the use of the Bayesian model as a potential limitation.
“Our model does not detect the potential impact of the implementation of lung cancer screening or programs to stop smoking among women in the next years in some countries. However, we have validated the model with previous data of lung mortality and provide good predictions,” Martínez-Sánchez said. “Moreover, we projected age-standardized mortality rates that are more robust than crude because we reduced the effect of the group of ages.”
The next step is to evaluate and compare the potential benefits of the implementation of smoking cessation and lung cancer screening among women.
“If we don’t work to reduce the impact of lung cancer among women we will know, in the [near] future, there will be women who overcame breast cancer but died of lung cancer,” Martínez-Sánchez said. – by Melinda Stevens
For more information:
Jose M. Martínez- Sánchez , PhD, MPH, BSc, can be reached at Universitat Internacional de
Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Valles; email: jmmartinez@uic.es.
Disclosures: The authors report no relevant financial disclosures.
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Martín-Sánchez JC, et al. Cancer Res. 2018;doi:10.1158/0008-5472.CAN-18-0187.
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