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Trends in cancer mortality in central european countries - the effect of age, birth cohort and time-period

Evstifeeva, T.V. and MacFarlane, G.J. and Robertson, C. (1997) Trends in cancer mortality in central european countries - the effect of age, birth cohort and time-period. European Journal of Public Health, 7 (2). pp. 169-176.

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An analysis of changes in mortality from major cancer sites and all cancer sites combined in 6 central European countries, considered as a Western group of countries [Germany (the former FRG), Switzerland and Austria) and an Eastern group of countries (Poland, Czechoslovakia and Hungary) is presented. Cancer mortality and population data have been obtained from the World Health Organization Mortality Database and are available over at least 20 years. They have been analysed using age-period-cohort models and birth-cohort and time-period effects are presented graphically. The group of Eastern countries shows consistent and continuing increases in male lung cancer risk in contrast to the pattern in the group of Western countries, where after increases in older cohorts, the risk has stabilized or gone down in male cohorts born after around 1910. Steady and continuous increases have been, in general, observed for women In both groups of countries. All tobacco- and alcohol-related cancers considered demonstrate very similar patterns in men: an initial decrease In mortality by birth cohort with a subsequent Increase In more recently born cohorts. While all the countries considered demonstrate continuing decreases in stomach cancer risk for both sexes, cohort-based increases have been observed In Eastern countries for colorectal cancer, prostate cancer and female breast cancer. These results demonstrate the magnitude of the increasing mortality from tobacco- and alcohol-related cancers In the countries considered and emphasize the importance and potential of public health measures In preventing such increases continuing in the future.