Regional differences in tobacco smoking and lung cancer in Portugal in 2018: a population-based analysis using nationwide incidence and mortality data

Journal Article · Thu Oct 01 00:00:00 EDT 2020 · BMJ Open

DOI:https://doi.org/10.1136/bmjopen-2020-038937· OSTI ID:1816819

Forjaz, Gonçalo ^[1]; Bastos, Joana ^[2]; Castro, Clara ^[3]; Mayer, Alexandra ^[4]; Noone, Anne-Michelle ^[5]; Chen, Huann-Sheng ^[5]; Mariotto, Angela B. ^[5]

---

1. National Cancer Institute, Bethesda, MD (United States). Division of Cancer Control and Population Sciences; Azores Oncological Centre, Azores (Portugal); OSTI
2. Francisco Gentil Portuguese Inst. for Oncology of Coimbra (Portugal). Centre Region Cancer Registry
3. Francisco Gentil Portuguese Inst. for Oncology of Porto (Portugal). Northern Region Cancer Registry; Univ. of Porto (Portugal). Inst. of Public Health. EPIUnit
4. Francisco Gentil Portuguese Inst. for Oncology of Lisbon (Portugal). Southern Region Cancer Registry
5. National Cancer Institute, Bethesda, MD (United States). Division of Cancer Control and Population Sciences

Objectives: This study aims to estimate the proportion of lung cancer cases and deaths attributable to tobacco smoking in Portugal in 2018, complemented by trends in incidence and mortality, by sex and region. Design: Cancer cases for 1998–2011 and cancer deaths for 1991–2018 were obtained from population-based registries and Statistics Portugal, respectively. We projected cases for 2018 and used reported deaths for the same year to estimate, using Peto’s method, the number and proportion of lung cancer cases and deaths caused by tobacco smoking in 2018. We calculated the age-adjusted incidence and mortality rates in each year of diagnosis and death. We fitted a joinpoint regression to the observed data to estimate the annual percentage change (APC) in the rates. Setting: Portugal. Results: In 2018, an estimated 3859 cases and 3192 deaths from lung cancer were attributable to tobacco smoking in Portugal, with men presenting a population attributable fraction (PAF) of 82.6% (n=3064) for incidence and 84.1% (n=2749) for mortality, while in women those values were 51.0% (n=795) and 42.7% (n=443), respectively. In both sexes and metrics, the Azores were the region with the highest PAF and the Centre with the lowest. During 1998–2011, the APC for incidence ranged from 0.6% to 3.0% in men and 3.6% to 7.9% in women, depending on region, with mortality presenting a similar pattern between sexes. Conclusion: Exposure to tobacco smoking has accounted for most of the lung cancer cases and deaths estimated in Portugal in 2018. Differential patterns of tobacco consumption across the country, varying implementation of primary prevention programmes and differences in personal cancer awareness may have contributed to the disparities observed. Primary prevention of lung cancer remains a public health priority, particularly among women.

• Research Organization: Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
• Sponsoring Organization: USDOE Office of Science (SC)
• Grant/Contract Number: SC0014664
• OSTI ID: 1816819
• Journal Information: BMJ Open, Journal Name: BMJ Open Journal Issue: 10 Vol. 10; ISSN 2044-6055
• Publisher: BMJ Publishing Group
• Country of Publication: United States
• Language: English

Related Subjects

60 APPLIED LIFE SCIENCES