Projections in Breast and Lung Cancer Mortality among Women: A Bayesian Analysis of 52 Countries Worldwide

Among women, lung cancer mortality rates have surpassed those for breast cancer in several countries. This reflects the breast cancer mortality declines due to access to screening and effective treatment alongside the entrance of certain countries in stages of the tobacco epidemic in which smoking becomes more prevalent in women. In this study, we project lung and breast cancer mortality until 2030 in 52 countries. Cancer mortality data were obtained from the WHO Mortality Database. Age-standardized mortality rates (ASMR), per 100,000, were calculated (direct method) for 2008 to 2014 and projected for the years 2015, 2020, 2025, and 2030 using a Bayesian log-linear Poisson model. In 52 countries studied around the world, between 2015 and 2030, the median ASMR are projected to increase for lung cancer, from 11.2 to 16.0, whereas declines are expected for breast cancer, from 16.1 to 14.7. In the same period, the ASMR will decrease in 36 countries for breast cancer and in 15 countries for lung cancer. In half of the countries analyzed, and in nearly three quarters of those classified as high-income countries, the ASMR for lung cancer has already surpassed or will surpass the breast cancer ASMR before 2030. The mortality for lung and breast cancer is higher in high-income countries than in middle-income countries; lung cancer mortality is lower in the latter because the tobacco epidemic is not yet widespread. Due to these observed characteristics of lung cancer, primary prevention should still be a key factor to decrease lung cancer mortality. Significance: The mortality for lung and breast cancer is projected to be higher in high-income countries than in middle-income countries, where lung cancer mortality is expected to surpass breast cancer mortality before 2030. (C) 2018 AACR.J.C. Martin-Sanchez, A. Gonzalez-Marron, C. Lidon-Moyano, N. Matilla-Santander, J.M. Martinez-Sanchez are supported by the Ministry of Universities and Research, Government of Catalonia (grant 2017SGR608).; The work of E. Negri, and C. La Vecchia was supported by the Italian Association for Research in Cancer (AIRC grant N. 18440) and M. Malvezzi by MIUR (Ministero dell'Istruzione, dell'Universita e della Ricerca), with a SIR (Scientific Independence of Young Researchers) 2014 grant (project N. RBSI1465UH).; The work of A. Ferro, A.R. Costa, L. Lopes-Conceicao, N. Lunet, and S. Morais was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology - FCT (Portuguese Ministry of Science, Technology and Higher Education) under the Unidade de Investigacao em Epidemiologia-Instituto de Saude Publica da Universidade do Porto (EPIUnit; POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013); L Lopes-Conceicao was also funded under the project A five-year prospective cohort study on the neurological complications of breast cancer: frequency and impact in patient-reported outcomes (POCI-01-0145-FEDER-016867, Ref. PTDC/DTP-EPI/7183/2014); individual PhD grants attributed to A. Ferro (PD/BD/105823/2014), A.R. Costa (SFRH/BD/102181/2014), and S. Morais (SFRH/BD/102585/2014) were funded by FCT and the Programa Operacional Capital Humano (POCH/FSE)