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Lung cancer mortality in Europe and the USA between 2000 and 2017: an observational analysis

Chinmay Jani, Dominic C. Marshall, Harpreet Singh, Richard Goodall, Joseph Shalhoub, Omar Al Omari, Justin D. Salciccioli, Carey C. Thomson
ERJ Open Research 2021 7: 00311-2021; DOI: 10.1183/23120541.00311-2021
Chinmay Jani
1Dept of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA
2Harvard Medical School, Boston, MA, USA
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  • ORCID record for Chinmay Jani
Dominic C. Marshall
3National Heart and Lung Institute, Imperial College London, London, UK
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Harpreet Singh
4Dept of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
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Richard Goodall
5Dept of Surgery and Cancer, Imperial College of London, London, UK
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Joseph Shalhoub
5Dept of Surgery and Cancer, Imperial College of London, London, UK
6Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
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Omar Al Omari
1Dept of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA
2Harvard Medical School, Boston, MA, USA
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Justin D. Salciccioli
2Harvard Medical School, Boston, MA, USA
7Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA
9These authors contributed equally
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  • For correspondence: chinmay.jani@mah.harvard.edu
Carey C. Thomson
1Dept of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA
2Harvard Medical School, Boston, MA, USA
8Division of Pulmonary and Critical Care, Mount Auburn Hospital, Cambridge, MA, USA
9These authors contributed equally
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  • FIGURE 1
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    FIGURE 1

    Lung cancer age-standardised death rates for males and females.

  • FIGURE 2
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    FIGURE 2

    Trends in age-standardised death rates (ASDRs) per 100 000 for lung cancer. Squares indicate male mortality; circles indicate female mortality.

  • FIGURE 3
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    FIGURE 3

    Trends in the ratio of male:female mortality for lung cancer between 2001 and 2017.

Tables

  • Figures
  • TABLE 1

    Age-standardised death rate in males and females

    CountryStart pointEnd pointOverall percentage change in mortality
    Year of diagnosisAge adjusted rate in malesAge adjusted rate in femalesYear of diagnosisAge adjusted rate in malesAge adjusted rate in females
    MalesFemales
    Austria200038.9212.35201728.4414.80−10.482.45
    Belgium200060.6311.30201640.4016.80−20.235.50
    Bulgaria200038.386.83201541.839.513.452.68
    Croatia200074.0912.51201654.7915.48−19.302.97
    Cyprus200428.284.25201625.748.34−2.544.09
    Czech Republic200063.2712.88201735.9314.76−27.341.88
    Denmark200046.7928.77201533.4329.65−13.360.88
    Estonia200060.966.91201642.6910.26−18.273.35
    Finland200035.138.65201625.5411.07−9.592.42
    France200047.257.80201441.0214.08−6.236.28
    Germany200043.7711.45201632.7916.50−10.985.05
    Greece200052.288.18201650.0911.77−2.193.59
    Hungary200084.8123.24201764.5131.04−20.307.80
    Ireland200043.4420.41201530.4420.05−13.00−0.36
    Italy200049.629.27201536.2512.20−13.372.93
    Latvia200057.756.12201541.728.34−16.032.22
    Lithuania200055.355.49201741.787.58−13.572.09
    Netherlands200055.5917.69201638.2224.79−17.377.10
    Poland200069.8713.13201653.0018.95−16.875.82
    Portugal200029.665.44201631.267.701.602.26
    Romania200047.438.11201747.4611.710.033.60
    Slovakia200062.258.59201442.1410.72−20.112.13
    Slovenia200054.4411.02201543.4215.88−11.024.86
    Spain200048.825.12201541.049.61−7.784.49
    Sweden200022.4314.19201617.3115.67−5.121.48
    UK200142.0621.49201630.6622.05−11.400.56
    USA#200076.7041.30201744.3030.60−32.40−10.70

    Luxembourg and Malta were excluded due to data quality. #: USA data are standardised based on US population. CDC WONDER database is used for data collection in the USA.

    • TABLE 2

      Joinpoint analysis for lung cancer mortality of males and females in 25 EU countries, UK and USA for years 2000 to 2017, where data available

      CountryTrend 1Trend 2Trend 3Trend 4
      YearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPC
      USA#2000–2005−2.2−2.4– −1.92005–2010−2.7−3– −2.32010–2014−3.6−4.1– −3.12014–2017−5.1−5.6– −4.6
      Cyprus2004–20161.4−0.3–3.2
      Austria2000–2013−1.4−1.7– −1.12013–2017−3.5−5.3– −1.6
      Belgium2000–2010−1.6−2– −1.22010–2016−4.2−5.1– −3.3
      Bulgaria2000–200631.6–4.52006–2015−0.7−1.5–0
      Croatia2000–2002−8.9−12.8– −4.92002–2016−0.9−1.1– −0.7
      Czech Republic2000–2017−3.3−3.6– −3.1
      Denmark2000–2015−2.1−2.4– −1.7
      Estonia2000–2016−1.7−2.3– −1.1
      Finland2000–2016−1.9−2.3– −1.5
      France2000–2006−0.3−0.7–02006–2014−1.5−1.7– −1.3
      Germany2000–2006−2.2−2.5– −1.92006–2013−1.1−1.4– −0.82013–2016−2.5−3.4– −1.5
      Greece2000–2011−0.4−0.8–02011–20142.8−2.8–8.72014–2016−3.2−8.4–2.3
      Hungary2000–2017−1.4−1.7– −1.1
      Ireland2000–2015−1.4−2– −0.9
      Italy2000–2012−1.9−2– −1.72012–2015−3.3−4.3– −2.4
      Latvia2000–2013−1.1−1.7– −0.52013–2015−9.6−20–2.1
      Lithuania2000–2017−1.4−1.8– −1
      Netherlands2000–2016−2.5−2.7– −2.2
      Poland2000–2015−1−1.9– −0.12005–2016−2.3−2.5– −2
      Portugal2000–20160.50.1–0.8
      Romania2000–20100.60.2–0.92010–2017−0.5−1.1–0.1
      Slovakia2000–2014−2.2−2.6– −1.7
      Slovenia2000–2015−1.8−2.4– −1.2
      Spain2000–20030.2−1.3–1.72003–2011−1.2−1.6– −0.82011–2015−2.3−3.2– −1.4
      Sweden2000–20050.5−1.5–2.62005–2016−2.5−3.1– −1.9
      UK2001–2009−1.7−2– −1.42009–2016−2.5−2.9– −2.2

      EAPC: estimated annual percentage change. #: USA data are standardised based on US population. CDC WONDER database is used for data collection in the USA.

      • TABLE 3

        Joinpoint analysis for lung cancer mortality of females in 25 EU countries, UK and USA for years 2000 to 2017, where data available

        CountryTrend 1Trend 2Trend 3Trend 4
        YearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPCYearsEAPC95% CI of EAPC
        USA#2000–20030.2−0.7–12003–2009−1.1−1.5– −0.72009–2014−2.2−2.7– −1.62014–2017−4.2−5– −3.4
        Cyprus2004–2016−2–5.4
        Austria2000–20171.81.3–2.3
        Belgium2000–20114.23.5–4.82011–2016−0.1−2.1–1.9
        Bulgaria2000–20152.21.5–2.9
        Croatia2000–20162.41.8–3
        Czech Republic2000–20170.70.4–1.1
        Denmark2000–20051.7−0.4–3.92005–2015−0.9−1.7– −0.2
        Estonia2000–201621.2–2.8
        Finland2000–20161.91.6–2.3
        France2000–20056.65.1–8.12005–20142.82.2–3.4
        Germany2000–20112.92.6–3.12011–201610.2–1.8
        Greece2000–20050.1−1.5–1.72005–20163.73.2–4.2
        Hungary2000–20172.11.7–2.5
        Ireland2000–20061.9−0.1–3.82006–2015−0.4−1.5–0.6
        Italy2000–20151.91.8–2.1
        Latvia2000–20151.20.1–2.4
        Lithuania2000–20171.10.3–1.9
        Netherlands2000–20074.23.4–52007–20160.80.3–1.4
        Poland2000–20162.42.1–2.7
        Portugal2000–20162.62.1–3.1
        Romania2000–20172.32–2.6
        Slovakia2000–20142.41.7–3.1
        Slovenia2000–20152.52–3.1
        Spain2000–20154.44.1–4.7
        Sweden2000–20053.51.2–5.92005–2016−0.5−1.2–0.2
        UK2001–20081.71.1–2.32008–2016−0.7−1.2– −0.2

        #: USA data are standardised based on the US population. CDC WONDER database is used for data collection in the USA.

        • TABLE 4

          Post hoc analysis of the male-to-female ratio of lung cancer mortality

          CountryStart pointEnd point
          Year of diagnosisSex ratioYear of diagnosisSex ratio
          Spain20009.5320154.27
          Estonia20008.8220164.16
          Lithuania200010.0720175.51
          Latvia20009.4420155.00
          Cyprus20046.6520163.08
          Slovakia20007.2520143.93
          France20006.0620142.91
          Belgium20005.3720162.41
          Poland20005.3220162.80
          Czech Republic20004.9120172.43
          Croatia20005.9220163.54
          Italy20005.3520152.97
          Slovenia20004.9420152.74
          Greece20006.3920164.26
          Germany20003.8220161.99
          Romania20005.8520174.05
          Finland20004.0620162.31
          Netherlands20003.1420161.54
          Hungary20003.6520172.08
          Portugal20005.4520164.06
          Austria20003.1520171.92
          Bulgaria20005.6220154.40
          Ireland20002.1320151.52
          UK20011.9620161.39
          Denmark20001.6320151.13
          Sweden20001.5820161.10
          USA#20001.8620171.45

          #: USA data is standardised based on the US population. CDC WONDER database is used for data collection in the USA.

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          Lung cancer mortality in Europe and the USA between 2000 and 2017: an observational analysis
          Chinmay Jani, Dominic C. Marshall, Harpreet Singh, Richard Goodall, Joseph Shalhoub, Omar Al Omari, Justin D. Salciccioli, Carey C. Thomson
          ERJ Open Research Oct 2021, 7 (4) 00311-2021; DOI: 10.1183/23120541.00311-2021

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          Lung cancer mortality in Europe and the USA between 2000 and 2017: an observational analysis
          Chinmay Jani, Dominic C. Marshall, Harpreet Singh, Richard Goodall, Joseph Shalhoub, Omar Al Omari, Justin D. Salciccioli, Carey C. Thomson
          ERJ Open Research Oct 2021, 7 (4) 00311-2021; DOI: 10.1183/23120541.00311-2021
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