Cancer mortality in Europe: effects of age, cohort of birth and period of death

Death certification data for 19 cancers or groups of cancers, plus total cancer mortality, in 16 major European countries were analysed using a log-linear Poisson model with arbitrary constraints on the parameters to disentangle the effects of age, birth cohort and period of death. Three major patte...

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Bibliographic Details
Published in:European journal of cancer (1990) 1998-01, Vol.34 (1), p.118-141
Main Authors: La Vecchia, C, Negri, E, Levi, F, Decarli, A, Boyle, P
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Biological and medical sciences
Breast Neoplasms - mortality
cancer mortality
Cohort Studies
Digestive System Neoplasms - mortality
Epidemiology
Europe - epidemiology
Female
Hematologic Neoplasms - mortality
Humans
Male
Medical sciences
Middle Aged
Neoplasms - mortality
Skin Neoplasms - mortality
smoking
statistical modelling
Tumors
Urologic Neoplasms - mortality
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Summary:Death certification data for 19 cancers or groups of cancers, plus total cancer mortality, in 16 major European countries were analysed using a log-linear Poisson model with arbitrary constraints on the parameters to disentangle the effects of age, birth cohort and period of death. Three major patterns emerged including: first, the prominent role of cohort of birth in defining trends in mortality from most cancer sites (except testis or Hodgkin’s disease, where newer treatments had a major period of death effect); and second, the major role of lung and other tobacco-related neoplasm epidemics in determining the diverging pattern of cancer mortality, for each sex and in various European countries and geographic areas. In most countries, the peak male cohort values were reached for generations born between 1900 and 1930. This was observed in women only for Denmark and the U.K., i.e. the two countries where lung and other tobacco-related neoplasm epidemics had already reached appreciable levels. This confirms the importance of cigarette smoking in subsequent generations as a major cause of cancer deaths in Europe. Further, there is a persistent rise in several cancer rates, again chiefly on a cohort basis, in Eastern Europe, which calls for urgent intervention to control the cancer burden in these countries.
ISSN:0959-8049
1879-0852
DOI:10.1016/S0959-8049(97)00335-3