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CANCER MARCH 15, 2019 A lthough the breast cancer mortality rate for women around the world is expected to decline by 9% between 2015 and 2030, the global lung cancer mortality rate for women could increase by 43% in the same time period, according to a recent study published in the journal Cancer Research.1 Using data from the World Health Organization (WHO) Mortality Database, investigators examined female breast and lung cancer mortality between 2008 and 2014. They focused on 52 countries, including 29 from Europe, 14 from the Americas, 7 from Asia, and 2 from Oceania. Calculations for lung and breast cancer age-standardized mortality rates among women— reported as per 100,000 person-years—were based on the WHO World Standard Population to allow for the comparison of countries with different age distributions. Among the key findings: • The global lung cancer mortality rate for women is projected to increase from 11.2 per 100,000 personyears in 2015 to 16.0 in 2030. • Europe and Oceania are projected to have the highest lung cancer mortality rates in 2030, whereas America and Asia are projected to have the lowest. • Only Oceania is predicted to have a decline in lung cancer mortality, with its rate projected to fall from 17.8 per 100,000 person-years in 2015 to 17.6 in 2030. • High-income countries are projected to have the highest age-standardized mortality rates for both lung and breast cancer in 2030; however, they are more likely than middle-income countries to have decreasing breast cancer mortality rates. • Breast cancer mortality rates among women are projected to decrease from 16.1 per 100,000 personyears in 2015 to 14.7 in 2030, with the highest mortality rate predicted in Europe (although with a decreasing overall trend) and the lowest mortality rate predicted in Asia (although with an increasing overall trend). This reflects changing lifestyle factors in Asia, where the population is adopting more Westernized diets and alcohol intake patterns that can contribute to breast cancer risk. Conversely, Europe has experienced improvements in awareness of, screening for, and treatment of the disease. The findings point to the pressing need to reduce smoking among women worldwide, says lead author Jose MartínezSánchez, PhD, MPH, associate professor and director of the public health, epidemiology, and biostatistics department at the International University of Catalonia in Barcelona, Spain. Nevertheless, both the authors and others in the fields of cancer epidemiology and tobacco control say that the analysis has several limitations. For example, as Dr. Martínez-Sánchez and colleagues note, the study assumes recent trends in lung and breast cancer mortality will continue through 2030. Such a premise, however, leads Ahmedin Jemal, DVM, PhD, vice president of surveillance and health services research at the American Cancer Society in Atlanta, Georgia, to consider the results with caution. “The problem is it’s a big assumption that the trend for the last 6 to 7 years will remain unchanged for the next 15 years,” Dr. Jemal says. “In order to project for the future in lung cancer, you have to know the tobacco epidemic trend in each specific country—you need data for the last 50 to 60 years or more.” An assessment of the tobacco epidemic trend among women in the United States demonstrates that those born in the 1930s New research suggests that, among women, strides in reducing global deaths from breast cancer could be tempered by rising lung cancer deaths. However, according to experts, the projections may not reveal the full picture. Study Projects a 43% Increase in Lung Cancer Mortality Among Women © M IN ER VA S TU D IO / SH U TT ER ST O C K .C O M