Estimation and projection of population lung cancer trends (United Kingdom)

Objective: Reduction of overall cancer mortality in the UK will require a marked decrease in lung cancer incidence and mortality. A method was sought to predict future lung cancer trends at regional and subregional levels to improve planning, aid the monitoring of health promotion strategies, and to assess health gains that might be achieved. Methods: Data on 55,000 lung cancer patients were used in an age-cohort model of lung cancer incidence (1981-95) and a parametric model of survival (1981-91). Indicators of deprivation were included in the models. Prevalence was estimated from the product of incidence and survival. Lung cancer trends were predicted to 2015, both at steady state and with an incidence perturbation. Results: Female lung cancer is predicted to increase, until by 2015 the numbers will almost equal those in men. Cohort coefficients reveal an increasing risk of lung cancer in females born after 1941. Changing these female cohort coefficients to equate to a declining risk after 1941 suggests that, by 2015, around 200 cases per year might be prevented. This would necessitate a marked change in smoking behavior. Survival from lung cancer was significantly associated with social deprivation and health authority of residence. Conclusions: A credible model has been derived which can be used for health service and outcome monitoring. The model results have highlighted a priority area for smoking intervention which currently seems to attract little attention.