A Decrease in Lung Cancer Mortality Rates over the last 30 years, also for women


Over the last 30 years, the lung cancer mortality rate in Italy has decreased, and not only among men, but also women. Published in the International Journal of Cancer, such findings are found in the study Epidemiologic transition of lung cancer mortality in Italy by sex, province of residence and birth cohort (1920-1929 to 1960-1969) conducted by the Istituto Superiore di Sanità, the Italian National Institute of Statistics, the Emilia-Romagna Cancer Registry, and the University of Padua.

With the Italian National Institute of Statistics (ISTAT) providing the anonymous records, researchers investigated the spatial-temporal evolution of lung cancer mortality rates in Italy over the past 30 years by marking gender, Italian province of residence, and by using the birth cohort as relevant time axis.

The study confirms the general decline in the mortality rate of men, which peaked in older cohorts (those born between 1920 and 1929) against younger cohorts (those born between 1960 and 1969), with a marked risk decrease by 83%. However, the mortality rate of women, which peaked in those born between 1955 and 1964, witnessed a delay of approximately 35 years compared to men, followed by a marked decrease in risk of 43%. While the most common approach to the analysis of the temporal evolution of lung cancer is the period approach, this study is the first to evaluate the temporal and spatial evolution of lung cancer mortality by gender and province of residence, taking the birth cohort as relevant time axis.

As in other European countries, Italian males and females fall within different phases of the lung cancer epidemic but are linked to changes in behavior and lifestyle. The study also revealed a strong geographical variance. For older cohorts, researchers analyzed a north to south mortality gradient, with northern regions at higher risk, while replaced in younger cohorts by an east to west gradient, with western regions at higher mortality. In the younger cohorts, Naples holds the highest mortality risk in Italy, both among men but especially among women (in women the youngest cohort has a mortality risk of 2.2 times the national average). This trend is consistent with a greater prevalence of risk factors, especially smoking habits, for lung cancer in populations residing in the south-west of Italy.