Cancer Research UK : UK Lung Cancer mortality statistics

UK Lung Cancer mortality statistics

This page presents lung cancer mortality statistics including by age, time trends,geographical variation deprivation and ethnicity.

Lung cancer has an enormous impact on national mortality and currently accounts for 6% of all deaths and 22% of all deaths from cancer in the UK (Figure 2.1). One person dies of lung cancer almost every 15 minutes in the UK 1-3.

Figure 2.1: Lung cancer deaths as a percentage of all cancer deaths

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Lung cancer is the most common cause of death from cancer for both men and women, responsible for nearly a quarter (24%) of all male cancer deaths and nearly a fifth (19%) of all female cancer deaths. The numbers of deaths from lung cancer and the mortality rates for the constituent countries of the UK are shown in Table 2.1.

Table 2.1: Number of deaths and mortality rates, lung cancer, UK

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Lung cancer mortality rates by age

Figure 2.2 shows the ages at which people die from lung cancer:three-quarters die at age 65 and over, but due to the very large numbers of lung cancer deaths overall, over 4,000 people die from lung cancer before the age of 60.

Figure 2.2: Numbers of deaths and age-specific mortality rates by sex, lung cancer, UK

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Lung cancer mortality trends

The importance of lung cancer as a cause of death has grown throughout most of the twentieth century. In the early 1900s, lung cancer was a rare disease causing fewer than 10 male deaths annually in every 100,000 men.

By the 1950s, the lung cancer death rate had risen six-fold, prompting the first epidemiological study that linked tobacco smoking and lung cancer in Britain4. By the 1980s, the death rate for lung cancer was over 100 per 100,000 men. From the early 1980s onwards, the male lung cancer mortality rates have fallen continuously.

The striking mortality trends by age over the past fifty years for men and women in England and Wales are shown in Figure 2.3 and Figure 2.41, 19.

Figure 2.3:Age-specific mortality of lung cancer, males, England and Wales,

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Male lung cancer death rates are higher than female rates in each age group throughout the time period.

Figure 2.4: Age-specific mortality of lung cancer, females, England and Wales

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For men, lung cancer mortality rates peaked and then declined steeply for all age groups, beginning first with the youngest men and last for the over 85 year olds in the late 1980s.

For women, the lung cancer mortality rates rose for all age groups for most of the period until the late 1980s when rates began to fall in the 55-64 age group, followed by those of the 65-74 age group in the mid 1990s.

Rates in women aged over 75 years continued to rise during the 1990s and into the twenty-first century.

The different patterns of lung cancer death rates in men and women reflect past smoking behaviour: men started to smoke earlier and more heavily than women, but then male smoking cessation has resulted in falling lung cancer mortality rates.

The death ratios by birth cohort illustrate this clearly, with the highest rates for men born around the turn of the century and for women in the 1920s.

(Figure 2.5)6.

Figure 2.5 : Birth cohort mortality for lung cancer, males and females aged 35-84, England and Wales

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To summarise the more recent trends, the age-standardised lung cancer mortality rates for the countries of the UK between 1982 and 2005 are shown in Figure 2.6 and Figure 2.71-3.

Figure 2.6: Age-standardised mortality rates, male lung cancer for England, Wales, Scotland and Northern Ireland(NI)

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Scottish lung cancer mortality rates are consistently highest but the trend is the same in all.

Figure 2.7: Age-standardised mortality rates, female lung cancer for England, Wales, Scotland and Northern Ireland

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For men, lung cancer mortality rates decreased steadily between 1982 and 2005: in Scotland they fell from 118 to 72 per 100,000 population and in the rest of the UK rates have fallen to around 51-57 per 100,000 population.

Over the same time period, female mortality rates for lung cancer increased until the late 1990s and then levelled off. The prediction for Scotland up to 2010-14 is that male deaths from lung cancer will continue to fall while female deaths will increase slightly7.

Geographical variation of lung cancer mortality rates

Within the UK, variations in lung cancer mortality rates reflect regional smoking patterns. As with incidence, the highest male mortality rates are in Scotland (Table 2.1).

Within England and Wales there is a north/south differential, with lung cancer mortality rates higher in the north – again a reflection of regional smoking patterns5.

European lung cancer mortality rates also vary markedly (Figure 2.8)with age-standardised rates for Hungarian men three and a half times higher than those for Swedish men. Countries are at different stages in their lung cancer epidemic as a result of different histories of tobacco consumption and the long latent period between smoking and lung cancer development8-12.

Figure 2.8:Age-standardised mortality of lung cancer in the EU, 2006 estimates

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Male lung cancer mortality rates in the UK and many other European countries have decreased quite rapidly, together with falls in tobacco consumption. While female lung cancer mortality rates have begun to decline in the UK, especially in younger women, elsewhere in Europe, rates continue to climb and effective anti-smoking policies are urgently needed to control the epidemic of lung cancer in women.15

It may still be possible in some countries, for example Spain and Portugal, to prevent widespread smoking in disadvantaged women whose smoking prevalences are currently low.16 It is etimated that there are around 243,100 lung cancer deaths each year in the European Union (around 188,000 in men and 55,000 in women).17

Overall smoking is estimated to cause over half a million deaths each year in the EU and a million in Europe.18

Deprivation and lung cancer mortality

Lung cancer mortality rates have a clear positive association with deprivation, particularly for men.

For men aged 15-64 in England and Wales who died between 1999-2003, the lung cancer mortality rates were 3.7 times higher in the most deprived category compared with the least deprived category, when deprivation was divided into twentieths.20

Using deprivation quintiles, lung cancer mortality rates for both men and women aged 15-64 in England, were 2.8 times higher in the most deprived compared with the least deprived groups.20

This association is strongly related to smoking behaviour in different deprivation groups.

Ethnicity and lung cancer mortality

When 'country of birth' data is used as an approximation fo ethnic group, lung cancer is the most common cause of cancer death for men in all ethnic groups except West African.

However, the proportion of deaths due to lung cancer varies by country of birth, with the highest proportion in Scottish-born men and the lowest in Pakistani-born men.

Lung cancer is the most common cause of cancer death for women born in England and Wales, Scotland and Ireland, but not for other ethnic groups.

References

Office for National Statistics, 2007 Mortality Statistics: Cause, 2005
ISD Online, 2007 Cancer Incidence and Mortality data, 2005
Northern Ireland Statistics and Research Agency 2007 Northern Ireland Mortality data, 2005.
Doll, R. and A.B. Hill, Smoking and carcinoma of the lung. Preliminary report. British Medical Journal, 1950: p. ii:739-48.
Quinn M, Cooper N, Rowan S Cancer Atlas of the United Kingdom and Ireland 1991-2000 Office for National Statistics, 2005
Swerdlow, A.J., I. dos Santos Silva, and R. Doll, Cancer Incidence & Mortality in England & Wales: trends and risk factors. 2001: Oxford University Press.
Scottish Executive Health Department, Cancer Scenarios: An aid to planning cancer services in Scotland in the next decade. The Scottish Executive: Edinburgh.2001
J. Ferlay, P. Autier, M. Boniol, M. Heanue, M. Colombet, P. Boyle. Estimates of the cancer incidence and mortality in Europe in 2006 Ann Oncol. 2007 Mar;18(3):581-92.
Didkowska J, Manczuk M, McNeill A, et al.Lung cancer mortality at ages 35-43 in the European Union: ecological study of evolving tobacco epidemics BMJ 2005;331 (7510):189-91
Borras, J.M., et al., Lung cancer mortality in European regions (1955-1997). Annals of Oncology, 2003. 14: p. 159-161.
Brennan, P. and I. Bray, Recent trends and future directions for lung cancer mortality in Europe. Br J Cancer, 2002. 87(1): p. 43-8.
Levi, F., F. Lucchini, and E. Negri, Cancer Mortality in Europe, 1990-1994, and an Overview of Trends from 1955 to 1994. European Journal of Cancer, 1999. 35: p. 1477-1516.
Franco, J., S. Perez-Hoyos, and P. Plaza, Changes in lung cancer mortality trends in Spain. International Journal of Cancer, 2002. 97: p. 102-105.
Ferlay J, Bray F, Pisani P, et al. Globocan 2002: Cancer Incidence, Mortality and Prevalence Worldwide,Version 2.0: IARC CancerBase no.5, Lyon, IARCPress, 2004.
Bray F, Tyczynski JE, Parkin DM. Going up or coming down? The changing phases of thelung cancer epidemic from 1967 to 1999 in the 15 European Union countries Eur J Cancer 2004;40(1):96-125
Mackenbach JP, Huisman M, Andersen O, et al. Inequalities in lung cancer mortality by the educational level in 10 European populations Eur J Cancer 2004;40(1):36-125
Tyczynski JE, Bray F, Parkin DM. Lung cancer in Europe in 2000: epidemiology, prevention, and early detection Lancet Oncol 2003;4(1):45-55
European Commission Public Health: Tobacco. 2007
Quinn, M., et al., Cancer Trends in England & Wales 1950-1999. Vol. SMPS No. 66. 2001: TSO.
Romeri E, BAaGC Mortality by deprivation and cause of death in England and Wales, 1999-2003 National Statistics., Health Statistics Quarterly Winter 2006.