Current comprehensive lung cancer mortality in Europe and Northern America in relation to the new molecular therapy and screening advances is unknown.
We analysed vital registration data from the WHO Mortality Database (2000-17) covering Northern America and Eastern/Northern/Southern/Western Europe. To assess temporal trends in lung cancer mortality we performed a population-averaged Poisson autoregressive analysis. The average annual percent change (AAPC) calculated with a segmented regression was used as a summary measure of overall and country-specific trends in lung cancer mortality.
In the total population of 872·5 million people between 2015 and 2017, the average annual age-standardised mortality was 54·6 deaths per 100 000 with substantial differences across countries. Lung cancer was reported as the primary cause of death in 5·4 cases per 100 deaths. Age-standardised lung cancer mortality rate decreased constantly (AAPC –1·5%) from 2000 to 2017. Whilst male mortality dropped annually by an average of –2·3%, female mortality only decreased by an average of –0·3%, and this slight decline was driven exclusively by the United States. Conversely, 21 out of 31 countries registered a significant increase in female lung cancer mortality between 2000 and 2017, with Spain (AAPC 4·1%) and France (AAPC 3·6%) leading the list.
Despite the overall decreasing lung cancer mortality trends in Europe and Northern America, in all countries except the US female mortality remained either unchanged or increased. National mortality outcomes are very heterogenous and probably limited from variabilities in tobacco control, screening, and access of effective treatment.
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All authors have declared no conflicts of interest.