LUNG CANCER BECOME THE TOP CANCER KILLER IN WOMEN 

Lung cancer will soon overtake breast cancer as the top cause of cancer mortality in European women, according to the latest estimates.

In some countries it has already done so. More women die from lung cancer than from breast cancer in the United Kingdom and Poland, according to a report published onlineFebruary 12 in the Annals of Oncology.

These projections for 2013 were calculated from World Health Organization (WHO) mortality and population databases and the latest available data (2009 and 2010) from the European Union. The researchers analyzed data for all 27 countries in the European Union, and then analyzed data in detail for 6 countries: France, Germany, Italy, Poland, Spain, and the United Kingdom.

Overall, cancer mortality has been decreasing in the European Union. It is predicted that from 2009 to 2013, age-adjusted mortality rates for all cancers will fall by 6% in women and 4% in men, which continues the favorable downward trend first seen in the 1980s in men and even earlier in women.

In women, deaths from breast cancer have been falling steadily; there has been a 7% drop since 2009.

"This reflects important and accumulating advances in treatment, as well as screening and early diagnosis, " said coauthor Carlo La Vecchia, MD, head of the Department of Epidemiology at the Mario Negri Institute and professor of medicine at Milan University in Italy.

However, at the same time, there has been an increase in deaths from lung cancer in women in all countries included in this survey. Since 2009, lung cancer deaths have increased by 7% in women but have fallen by 6% in men.

If this opposite trend continues, lung cancer will overtake breast cancer as the top cancer killer of women by 2015, the researchers predict.

The United Kingdom has the highest rate of lung cancer deaths in women, and is estimated to reach 21.2 per 100,000 in 2013.

"This predicted rise of female lung cancer in the United Kingdom may reflect the increased prevalence of young women starting smoking in the late 1960s and 1970s," said Dr. La Vecchia in a statement.

"However, fewer young women nowadays...are smoking; therefore, deaths from lung cancer may start to level off after 2020, at around 15 per 100,000 women," he predicted.

The key message from this study is tobacco control, said coauthor Fabio Levi, MD, head of the cancer epidemiology unit at the Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.

Tobacco control is particularly important for "middle-aged men and women (i.e., the European generations most heavily exposed to smoking)," he said in a statement. "If more people could be helped and encouraged to give up smoking or to not take it up in the first place, hundreds of thousands of deaths from cancer could be avoided each year in Europe," he noted.

Increase in Pancreatic Cancer

Apart from the increase in lung cancer deaths in women, the only other cancer for which mortality is not declining is that of the pancreas. In fact, a slight rise in deaths from pancreatic cancer is predicted in 2013, the researchers warn.

Pancreatic cancer is the fourth cancer mortality site in the European Union for both sexes, having recently overtaken stomach cancer in both sexes, they note.

"The best way of preventing pancreatic cancer is to avoid tobacco and to avoid being overweight (and the consequent onset of diabetes that this can bring)," Dr. La Vecchia explained.

"This could prevent about one third of pancreatic cancers in the European Union," he said. "No other major risk factor is known, and there is nothing happening with regard to diagnosis and treatment that could materially influence national death rates," he said.

The authors have disclosed no relevant financial relationships.

Ann Oncol. Published online February 12, 2013. Abstract