Time trends of cancer incidence and mortality in Catalonia during 1993-2007

PURPOSE

To describe time trends of cancer in Catalonia, Spain, during the period 1993-2007.

METHODS/PATIENTS

Data have been provided by two population-based cancer registries, Girona and Tarragona, and the Catalan mortality registry. Cancer incidence in Catalonia has been estimated through modeling methods using data from these health structures.

RESULTS

During 2003-2007, there were 20,042 cancer cases and 9,842 deaths per year among men and 13,673 new cancer cases and 5,882 deaths among women. The most frequent incident cancers among men were prostate (N = 4,258), lung (N = 3,021), colorectal (N = 3,007) and bladder (N = 2,238), whereas among women they were breast (N = 3,907), colorectal (N = 2,088), corpus uteri (N = 734) and lung (N = 527). During 1993-2007, age-standardized incidence rates (ASIRs) rose 1.2 % per year among men [prostate (6.3 %), testis (5.7 %), kidney (2.9 %), liver (2.2 %) and colorectal (2.1 %)]. ASIRs decreased for stomach (-2.9 %), oral cavity and pharynx (-2.8 %), larynx (-2.7 %) and esophagus (-2 %). Among women, ASIRs only rose for lung (5.2 %), kidney (3.1 %), oral cavity and pharynx (2.6 %) and thyroid (1.6 %). ASIRs decreased for corpus uteri (-2.3 %), stomach (-1.7 %) and ovary (-1.6 %). Cancer mortality decreased -1.3 % per year among men and -2.1 % among women during the same period.

CONCLUSION

Among men, the decrease of incidence/mortality of tobacco-related tumors was related to a reduction of smoking prevalence. Among women, the stabilization of breast cancer incidence and the rise of lung cancer incidence are similar to that observed in most European regions. These results allow assessing the effectiveness of public health strategies and they pose new frontiers for cancer control in Catalonia.

[Cancer survival trends in Catalonia and comparison with Europe]

OBJECTIVE

To analyze survival in cancer patients in Catalonia for the diagnostic cohort for the period 1995-1999 and the survival trend for the period 1985-1999 and to compare this trend with that observed in the rest of Europe.

MATERIAL AND METHOD

We present the observed and relative 5-year survival rates for adult cancer patients resident in Tarragona and Gerona diagnosed between 1995 and 1999. To analyze the trend in survival, rates for the periods 1985-1989, 1990-1994 and 1995-1999 for patients living in Tarragona were analyzed. Relative survival rates for the 1995-1999 Tarragona and Gerona diagnosis cohort as a whole were compared with the European mean obtained in the EUROCARE- 4 project.

RESULTS

From 1995-1999, relative survival rates were 46.0% in males and 56.4% in females. For the most frequent types of cancer in males the rates were as follows: 76.5% prostate, 9.2% lung, 53.5% colon and rectum, 69.7% urinary bladder and 25.7% stomach. In females, the rates were 80.9% breast, 50.7% colon and rectum, 76.1% corpus uterine, 24.9% stomach and 36.9% ovary. For quinquenniums and for all cancers as a whole, the rates were 35.1%, 40.8% and 47.5% in males and 49.0%, 55.7% and 57.3% in females. The rate for all people combined in the period 1995-1999 was 50.2% in Tarragona- Gerona and was 51.9% in Europe.

CONCLUSIONS

Between the periods 1985-1989 and 1995-1999, relative survival rates increased 12 points in males and eight points in females. Similar values to the European mean were maintained throughout the 15 years of the study.

The impact of avoidable mortality on life expectancy at birth in Spain: changes between three periods, from 1987 to 2001

Objective:

To evaluate the impact of avoidable mortality on the changes in life expectancy at birth in Spain.

Methods:

Standard life table techniques and the Arriaga method were used to calculate and to decompose life expectancy (LE) changes by age, effects and groups of causes of avoidable mortality among three periods (1987–91, 1992–6 and 1997–2001). A list of causes of avoidable mortality reached by consensus and previously published in Spain was used.

Main results:

Life expectancy increased in all ages and both sexes. The main contribution to the increase of LE at birth was due to people over 50. Mortality in young adults produced a reduction in LE between the first two periods, but there was an important increase in LE between the last two periods; in both cases, this was the result of factors amenable to health policy interventions. The highest improvement in LE was due to non-avoidable causes, but avoidable mortality through health service interventions showed improvements in LE in those younger than 1 year and in those aged 45–75 years.

Conclusions:

Making a distinction between several groups of causes of avoidable mortality and using decomposition by causes, ages and effects allowed us to better explain the impact of avoidable mortality on the LE of the whole population and gave a new dimension to this indicator that could be very useful in public health.