Chapter 4: Cancer incidence in Canada: trends and projections (1983-2032) – Lung cancer - HPCDP: Volume 35, Supplement 1, Spring 2015

Chapter 4: Projections by Cancer Site

8. Lung cancer

Lung cancer is the second most common cancer and the leading cause of cancer death in both males and females in Canada. One in 11 males and 1 in 15 females can expect to be diagnosed with lung cancer in their lifetime, and 1 in 13 males and 1 in 18 females can expect to die from it.Endnote 1 The average annual number of new cases in 2003–2007 was 12 245 in males and 9865 in females (Tables 4.8.1 and 4.8.2), accounting for 15.2% and 13.3% of all male and female cancer cases, respectively (Figure 3.9). Lung cancer has a poor 5-year relative survival rate in Canada, at 14% in males and 20% in females for 2006–2008.Endnote 1

TABLE 4.8.1
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), lung cancer, males, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 165 15 10 0 5 70 50 5 5 0 0 0
45–54 935 95 70 20 30 300 340 25 30 5 15 0
55–64 2660 280 190 65 80 865 915 90 105 15 50 5
65–74 4135 455 300 120 145 1380 1340 130 160 20 70 10
75–84 3520 435 260 120 125 1145 1125 105 135 20 45 5
85+ 830 115 60 35 35 245 270 30 30 5 5 0
Total 12 245 1395 895 360 425 4000 4040 385 470 60 185 25
2008–12 <45 150 10 15 0 5 55 45 5 5 0 0 0
45–54 935 105 75 15 30 325 315 25 30 5 15 5
55–64 2775 305 220 65 90 905 940 85 105 10 60 5
65–74 4125 465 305 115 140 1330 1370 140 165 20 80 10
75–84 3620 445 290 115 120 1140 1205 110 130 20 50 5
85+ 1095 150 75 40 40 345 350 35 35 5 5 0
Total 12 695 1485 980 350 425 4100 4225 400 470 60 205 25
2013–17 <45 150 10 15 0 5 50 50 0 5 0 0 0
45–54 835 90 75 15 25 315 255 15 25 5 10 5
55–64 2885 335 245 65 95 955 960 85 100 10 60 5
65–74 4550 535 365 115 150 1475 1485 160 185 20 95 10
75–84 3600 445 300 110 120 1120 1200 115 130 20 55 5
85+ 1330 180 100 40 45 420 435 45 40 5 5 0
Total 13 350 1595 1100 350 445 4335 4385 425 480 65 230 25
2018–22 <45 180 10 15 0 5 50 60 0 5 0 0 0
45–54 715 65 70 10 25 280 210 15 20 5 10 5
55–64 2995 365 260 65 95 1065 935 80 95 10 55 5
65–74 4980 610 450 125 170 1635 1575 170 195 20 105 5
75–84 3895 490 335 110 130 1210 1300 135 145 25 65 5
85+ 1455 200 115 45 45 460 475 45 40 5 5 0
Total 14 225 1740 1245 355 475 4700 4555 450 500 65 245 25
2023–27 <45 215 10 15 0 5 50 65 0 5 0 0 0
45–54 730 65 70 10 25 275 235 15 20 5 10 5
55–64 2820 335 270 55 95 1090 795 65 90 10 50 10
65–74 5465 705 515 135 195 1865 1675 175 190 20 115 5
75–84 4560 595 430 125 145 1445 1465 165 175 25 80 5
85+ 1540 210 130 45 50 490 505 50 40 5 10 0
Total 15 335 1920 1425 375 515 5220 4740 475 520 65 260 30
2028–32 <45 215 10 15 0 5 50 60 0 5 0 0 0
45–54 905 70 75 10 25 285 290 15 20 5 10 5
55–64 2525 275 265 50 90 1025 680 60 75 10 45 10
65–74 5820 780 560 135 200 2140 1665 175 195 25 110 10
75–84 5170 700 540 140 175 1670 1615 175 190 25 90 5
85+ 1785 250 150 50 55 570 580 65 50 10 10 0
Total 16 420 2090 1610 390 555 5740 4885 490 535 70 265 35
TABLE 4.8.2
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), lung cancer, females, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 230 20 15 5 5 80 85 5 5 0 5 0
45–54 1110 120 80 25 35 345 415 25 40 5 15 5
55–64 2220 255 185 70 80 720 715 65 80 10 35 5
65–74 2980 395 240 95 115 1060 810 90 115 15 40 5
75–84 2575 360 200 85 110 930 685 75 95 10 20 5
85+ 750 115 60 30 35 255 200 20 25 5 0 0
Total 9865 1265 780 310 385 3390 2910 280 360 50 115 20
2008–12 <45 185 15 20 5 5 75 60 5 10 0 5 0
45–54 1170 120 95 25 35 360 460 30 40 5 20 5
55–64 2620 305 205 75 95 790 910 75 85 15 40 5
65–74 3460 445 290 115 125 1155 990 100 125 20 50 10
75–84 2920 385 250 95 120 1025 815 90 110 15 25 5
85+ 1130 170 85 45 50 395 310 35 40 5 5 0
Total 11 485 1450 940 360 430 3800 3545 335 410 60 145 25
2013–17 <45 185 15 20 5 10 80 60 5 10 0 5 0
45–54 960 100 85 20 35 315 355 25 40 5 25 5
55–64 2990 335 245 80 95 885 1080 90 90 10 45 10
65–74 4170 535 355 135 145 1295 1285 125 145 20 65 10
75–84 3250 435 290 105 130 1100 920 100 115 15 35 5
85+ 1475 200 125 60 65 510 435 50 50 5 5 0
Total 13 025 1620 1115 395 475 4190 4130 390 455 65 180 35
2018–22 <45 205 20 25 5 10 90 70 5 10 0 5 0
45–54 725 85 80 15 35 280 225 25 35 5 25 5
55–64 3060 330 270 75 100 920 1095 85 100 15 50 10
65–74 4815 620 400 140 155 1445 1555 145 160 20 75 15
75–84 3805 510 355 125 140 1220 1110 115 130 20 45 10
85+ 1725 230 150 60 70 580 530 55 60 10 10 0
Total 14 335 1790 1275 425 510 4535 4585 430 495 70 205 40
2023–27 <45 205 20 25 5 10 85 70 5 10 0 5 0
45–54 705 85 85 20 35 295 210 25 35 5 20 5
55–64 2510 275 240 65 95 825 820 70 95 15 50 10
65–74 5390 675 460 145 155 1610 1760 160 170 20 80 20
75–84 4545 620 430 140 160 1375 1309 135 155 20 55 10
85+ 1940 270 180 70 75 635 585 60 60 10 10 5
Total 15 300 1945 1420 445 535 4830 4840 455 525 70 220 45
2028–32 <45 220 20 25 5 10 90 75 5 10 0 5 0
45–54 755 95 95 20 40 325 235 25 35 5 20 5
55–64 1970 240 225 60 95 740 545 65 85 15 50 10
65–74 5465 665 500 140 165 1670 1740 155 180 20 90 20
75–84 5250 720 485 150 170 1550 1665 155 170 20 60 15
85+ 2285 310 215 85 80 705 720 70 70 10 10 5
Total 15 945 2050 1550 460 555 5075 4985 475 550 70 230 55

In 2003–2007, the incidence rates increased with age to peak in the 75–84 age group, at 567.3 per 100 000 in males and 297.6 per 100 000 in females (Tables 4.8.3 and 4.8.4).

TABLE 4.8.3
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), lung cancer, males, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 1.5 1.0 1.0 0.8 1.2 1.6 1.9 1.4 1.8 0.8 0.6 2.5
45–54 37.3 29.1 26.4 27.5 36.6 31.9 55.8 40.2 40.4 30.2 33.7 22.9
55–64 157.5 119.5 126.0 136.8 137.8 138.3 211.8 205.6 190.9 166.3 161.4 180.1
65–74 384.1 299.3 332.1 353.8 393.1 337.6 500.5 487.7 471.4 409.3 385.1 583.9
75–84 567.3 479.5 512.7 503.5 528.2 475.9 776.0 709.6 737.5 742.0 453.5 933.5
85+ 544.8 483.0 477.7 439.2 472.9 437.1 852.6 767.4 555.5 478.2 142.9 435.4
Total 70.7 56.6 60.3 61.9 67.2 60.9 96.2 89.5 86.2 77.5 61.9 97.4
2008–12 <45 1.4 0.8 1.1 0.8 1.2 1.4 1.9 1.2 1.5 1.5 1.2 2.8
45–54 33.6 28.5 24.3 21.3 29.2 30.4 47.4 38.0 37.9 30.6 32.5 36.6
55–64 135.3 106.7 113.4 111.8 127.1 118.9 185.7 163.9 163.3 106.7 153.0 107.3
65–74 333.2 265.0 290.6 314.3 344.4 287.1 437.7 443.4 409.6 373.0 359.1 409.0
75–84 518.8 434.2 494.4 477.5 489.8 424.0 716.5 688.2 641.1 663.9 454.0 716.8
85+ 521.7 457.0 441.3 455.9 462.6 425.3 757.0 700.3 542.7 522.4 161.7 577.7
Total 62.9 51.1 55.2 55.7 60.7 53.6 85.7 81.1 75.6 68.0 59.9 74.6
2013–17 <45 1.4 0.7 1.0 0.8 1.1 1.2 2.1 1.1 1.4 1.5 1.2 2.8
45–54 29.7 23.7 24.2 18.1 28.6 28.0 39.6 28.4 34.4 28.4 27.4 45.5
55–64 123.2 103.3 102.3 95.9 119.8 108.3 170.2 147.7 139.6 92.6 152.0 76.6
65–74 292.3 239.6 264.8 267.8 288.1 253.5 382.0 397.2 364.9 303.2 333.0 287.5
75–84 467.0 391.1 455.6 456.3 469.4 380.1 641.1 624.3 562.2 571.0 439.2 552.1
85+ 498.3 435.6 443.6 450.2 454.3 394.7 724.8 707.8 536.9 574.7 179.0 444.5
Total 56.5 46.7 51.0 49.9 55.2 48.1 76.8 73.2 67.2 59.0 57.1 57.4
2018–22 <45 1.6 0.7 1.0 0.8 1.1 1.2 2.5 1.1 1.4 1.5 1.2 2.8
45–54 27.6 18.6 24.1 16.9 27.1 27.0 36.6 27.3 32.9 27.1 27.4 56.5
55–64 115.4 102.7 96.2 85.3 109.0 105.8 153.9 139.9 126.7 86.6 141.1 102.2
65–74 263.2 223.5 248.4 233.4 269.3 230.6 346.3 342.5 323.9 232.7 315.9 164.4
75–84 419.7 358.8 417.9 420.6 429.1 343.5 566.1 575.2 510.4 533.1 413.7 411.9
85+ 459.5 408.8 413.3 434.3 436.4 364.6 657.3 665.7 455.1 526.9 192.3 432.1
Total 51.7 43.6 47.7 45.1 51.2 44.6 69.5 66.5 60.4 51.7 54.2 47.2
2023–27 <45 1.8 0.6 1.0 0.7 1.0 1.1 2.4 1.1 1.4 1.5 1.2 2.8
45–54 28.6 18.1 23.6 16.4 26.4 27.0 41.5 26.7 32.1 26.5 27.4 69.8
55–64 108.0 91.6 98.8 79.0 111.4 104.6 135.4 115.9 121.3 83.8 125.5 132.9
65–74 250.0 225.2 232.4 213.6 260.0 224.5 324.9 329.7 292.5 219.8 313.9 134.4
75–84 379.2 334.5 393.4 374.4 372.2 318.3 504.0 527.1 469.4 449.2 381.6 269.5
85+ 418.7 370.7 387.6 431.7 434.5 337.3 590.0 607.0 417.7 455.8 174.5 274.7
Total 48.6 41.4 45.6 41.5 48.6 42.8 64.0 61.2 55.9 46.8 51.4 42.5
2028–32 <45 1.8 0.6 0.9 0.7 1.0 1.0 2.4 1.1 1.3 1.5 1.2 2.8
45–54 33.4 17.7 23.2 15.9 25.7 26.6 47.3 26.2 31.4 25.8 27.4 86.2
55–64 103.7 77.9 99.9 77.1 109.1 104.6 128.3 114.1 119.3 81.0 125.5 170.7
65–74 238.5 226.0 226.0 196.7 248.0 224.4 297.3 307.5 274.0 213.7 288.5 172.6
75–84 348.8 319.8 374.7 336.1 362.2 297.2 463.8 461.5 423.0 368.4 367.3 150.3
85+ 379.4 350.4 355.3 387.0 383.3 309.9 518.9 574.3 381.9 468.3 164.7 211.1
Total 46.4 39.5 44.2 38.3 46.7 41.7 60.0 56.7 52.3 43.3 49.1 45.3
TABLE 4.8.4
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), lung cancer, females, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 2.0 1.3 1.5 1.6 1.6 1.8 3.2 2.1 2.0 2.3 1.8 0.0
45–54 44.1 35.0 32.9 32.0 39.6 36.6 67.3 42.7 49.9 44.5 34.3 47.5
55–64 127.2 108.5 124.4 146.4 136.1 110.2 157.0 141.0 144.9 148.3 103.2 178.2
65–74 250.2 251.5 246.1 251.0 270.9 231.0 266.5 300.4 304.6 311.5 194.3 508.3
75–84 297.6 310.5 298.2 282.3 320.7 276.8 316.9 342.8 345.3 302.3 178.7 646.9
85+ 218.6 235.9 218.9 191.3 227.0 203.1 245.6 234.7 209.1 246.6 47.0 193.1
Total 47.1 44.7 45.0 46.4 49.4 42.4 55.0 53.3 54.5 53.8 34.0 80.2
2008–12 <45 1.8 1.2 1.6 1.5 2.1 1.8 2.5 2.2 2.9 2.4 2.0 0.6
45–54 42.1 32.3 33.1 28.3 36.9 33.4 70.0 45.2 48.6 50.3 47.4 46.9
55–64 123.0 103.4 107.2 124.3 128.2 98.8 171.9 140.3 127.8 125.9 104.1 116.9
65–74 255.7 240.5 258.2 297.3 277.4 223.6 285.1 300.4 288.4 301.1 215.2 502.7
75–84 323.0 321.6 340.3 322.2 364.4 291.4 355.3 403.9 396.7 353.1 208.1 616.5
85+ 260.2 279.6 246.6 267.5 266.1 240.9 297.2 304.9 283.8 231.3 66.8 367.7
Total 48.0 44.0 46.2 49.3 51.2 41.5 59.3 56.6 55.0 53.4 38.2 75.6
2013–17 <45 1.8 1.2 1.7 1.6 2.3 1.9 2.5 2.5 3.0 2.4 2.0 0.6
45–54 34.3 25.7 30.0 25.3 38.2 28.7 55.8 41.3 50.7 54.6 54.3 47.0
55–64 123.2 98.6 102.4 112.6 117.1 96.6 184.5 146.9 123.9 108.7 110.0 157.5
65–74 247.0 226.4 244.7 289.3 258.4 202.9 300.7 289.7 268.8 262.5 218.8 346.8
75–84 338.5 335.6 361.8 359.4 390.8 294.7 381.3 417.9 388.8 389.3 226.9 585.5
85+ 289.5 284.3 293.9 316.6 302.5 261.8 344.2 388.8 340.5 278.9 87.0 449.3
Total 47.5 42.5 45.9 49.4 50.5 39.8 61.3 57.5 53.9 51.6 40.6 68.2
2018–22 <45 1.9 1.2 1.8 1.7 2.4 2.1 2.8 2.7 3.1 2.4 2.0 0.6
45–54 28.4 23.2 29.8 26.6 40.2 26.9 41.3 44.4 51.8 57.7 59.4 47.1
55–64 115.7 88.8 101.0 103.2 114.5 89.6 177.9 138.6 123.0 118.0 121.8 157.7
65–74 235.6 212.7 213.5 245.4 227.0 185.9 314.3 276.3 247.7 210.9 205.7 282.3
75–84 338.5 329.0 369.7 397.1 381.6 282.4 390.5 409.6 369.9 343.6 231.4 603.6
85+ 305.8 297.4 308.1 335.3 330.7 267.3 374.3 398.8 362.8 289.2 116.5 362.7
Total 45.6 40.3 44.1 47.3 48.4 37.5 60.9 56.1 52.1 47.6 41.7 63.6
2023–27 <45 1.8 1.3 1.8 1.7 2.4 1.8 2.9 2.8 3.1 2.4 2.0 0.6
45–54 27.7 23.3 30.4 27.3 41.2 28.8 38.7 46.1 52.4 59.3 62.1 47.1
55–64 95.1 73.0 90.8 90.8 112.8 77.7 140.2 120.5 125.1 122.9 126.6 157.8
65–74 230.8 202.8 203.1 221.6 204.4 180.2 319.6 274.8 237.2 183.4 205.2 344.1
75–84 318.6 308.0 339.1 368.5 344.0 252.7 394.1 376.0 337.2 283.6 215.9 373.5
85+ 309.9 307.1 321.1 370.9 336.7 264.6 376.7 390.0 331.4 304.2 108.8 372.6
Total 42.7 37.7 41.6 44.0 45.5 35.1 58.0 53.4 50.2 44.4 41.8 59.7
2028–32 <45 1.8 1.3 1.9 1.7 2.5 1.8 3.0 2.8 3.1 2.4 2.0 0.6
45–54 27.6 23.5 30.9 28.0 42.3 29.2 40.0 47.8 53.0 61.0 64.9 47.2
55–64 80.1 66.5 88.9 92.6 115.2 73.1 106.0 124.1 126.2 128.0 131.5 158.0
65–74 212.7 181.4 195.3 198.0 196.7 165.4 298.7 248.8 234.9 190.3 216.2 344.3
75–84 302.6 289.6 294.8 310.6 298.2 233.2 402.7 353.1 312.4 217.6 196.5 365.1
85+ 301.6 289.1 318.1 400.3 310.9 245.6 376.7 367.6 318.6 225.6 109.5 386.1
Total 39.6 34.8 39.4 40.9 43.5 32.8 54.2 51.2 49.2 42.3 42.6 59.6

The overall lung cancer rates were lower in males under age 55 than in females for 2003–2007, and the rates in males aged 55 or older were higher than the female rates in the whole observation period (Figure 4.8.2). The male-to-female ratio of incidence rates increased with age to 2.5:1 in people aged 85 or older in 2003–2007.

Lung cancer incidence rates for males have dropped over the entire observation period and showed a slowing increase for females (Figure 4.8.1). Between 1998 and 2007, the lung cancer incidence rates decreased significantly in males by 1.8% per year but increased significantly in females by 1.1% per year (Figures 3.1 and 3.2). All the regions have had a consistent decrease over the whole observed period for males. Rates for females have increased in each region although they have stabilized in British Columbia since 1993–1997 and in Ontario 5 years later (Figure 4.8.1).

FIGURE 4.8.1
Age-standardized incidence rates (ASIRs) by region, lung cancer, 1983–2032

Age-standardized incidence rates (ASIRs) by region, lung cancer, 1983–2032

[Click to enlarge]

[FIGURE 4.8.1, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.8.1
Age-standardized incidence rates (ASIRs) by region, lung cancer, 1983-2032

Lung cancer incidence rates for males have dropped over the entire observation period and showed a slowing increase for females. The analysis predicts a steeper decrease in rates for males in the east (Ontario, Quebec and the Atlantic region) than in the west. For females, the rates will decrease in Ontario and British Columbia, and increase until 2013-2017 in Quebec and until 2008-2012 in other regions, followed by a gradual decrease. This projected future downturn of the rates is because of a decrease in rates in later birth cohorts. Quebec is predicted to continue to have the highest rates of lung cancer in both sexes.

The analysis predicts a steeper decrease in rates for males in the east (Ontario, Quebec and the Atlantic region) than in the west (Figure 4.8.1). For females, the rates will decrease in Ontario and British Columbia, and increase until 2013–2017 in Quebec and until 2008–2012 in other regions, followed by a gradual decrease. This projected future downturn of the rates is because of a decrease in rates in later birth cohorts. Quebec is predicted to continue to have the highest rates of lung cancer in both sexes. The differences in ASIRs in females between Quebec and the other regions will increase from between 10% and 30% in 2003–2007 to between 33% and 65% in 2028–2032. These increased differences are not evident in males.

The male-to-female ratio of ASIRs for lung cancer in Canada has decreased from 3.1:1 to 1.5:1 over the observed period (1983–2007), and is projected to further decrease to 1.2:1 in 2028–2032 (Figures 4.8.1 and 4.8.2).

From 2003–2007 to 2028–2032, the ASIRs of lung cancer for Canada are projected to decrease in males by 34%, from 70.7 to 46.4 per 100 000, and to peak and then also decrease in females by 16%, from 47.1 to 39.6 per 100 000. Because of the aging and growth of the population, the annual number of new cases is projected to increase by 34% in males (from 12 245 to 16 420) and by 62% in females (from 9865 to 15 945).

FIGURE 4.8.2
Age-standardized incidence rates (ASIRs) for lung cancer by age group, Canada, 1983–2032 (red lines denote males, blue lines denote females)

Age-standardized incidence rates (ASIRs) for lung cancer by age group (males, females), Canada, 1983–2032

[Click to enlarge]

[FIGURE 4.8.2, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.8.2
Age-standardized incidence rates (ASIRs) for lung cancer by age group, Canada, 1983-2032

The male-to-female ratio of incidence rates for lung cancer increased with age to 2.5:1 in people aged 85 or older in 2003-2007. The ASIRs are expected to decrease in males aged 45 and older, and in females under 65. The female rates are projected to peak in 2008-2012, 2013-2017 and 2023-2027 for the 65-74, 75-84 and 85+ age groups, respectively, and then decrease. The long-term trends of the rates in males and females are projected to converge in each age group.

Comments

Smoking causes about 90% of lung cancer deaths in males and between 75% and 80% in females in the US.Endnote 128, Endnote 129 The trends in lung cancer incidence rates in Canada have closely mirrored historical patterns of smoking prevalence,Endnote 42, Endnote 43 after accounting for a latency period of 20 years or more. Because smoking prevalence began to decrease in the mid-1960s in males and in the mid-1980s in females,Endnote 42, Endnote 43 lung cancer incidence rates decreased for males over the whole observation period and showed the slowing of increase for females. The rates of lung cancer decreased from 1993–1997 to 2003–2007 in females aged less than 45, were relatively stable in women aged 45 to 54, showed a slowing increase in those aged between 55 and 64, and increased in those aged 65 or older. These trends are in agreement with the fact that the onset of cigarette smoking starts at younger ages and then follows the birth cohort as it ages, and lung cancer rates increase as the birth cohort ages.

Figure 4.8.3 shows the different results for projected lung cancer incidence in males and the similar results for females based on age–period–cohort models that include and exclude adjustment for available smoking prevalence data in Canada. In males, for the models with the same parameter settings (cut trend and using recent 10-year slope), the models incorporating smoking rates predict lower lung cancer incidence rates as compared with the models without adjustment for smoking, echoing the decreased pattern of tobacco consumption. In the absence of incorporating smoking information into the model, we projected the current trend in a larger extent (model M1T) than the default gradual damping of the impact of the current trend in future periods (model M0T), on the assumption that the current trend will continue into the future. The projected lung cancer pattern in males follows the forecast derived from the default Nordpred drift reduction model (M0T) with adjustment for smoking. The different reactions of the projection models to smoking factors for males and females are related to the different historical patterns of tobacco consumptionEndnote 42, Endnote 43 and the lag of at least 20 years between a drop in smoking rates and subsequent decrease in cancer incidence rates.

FIGURE 4.8.3
Age-standardized incidence rates (ASIRs) with and without adjustments for smoking prevalence rates, lung cancer, Canada, 1983–2032

Age-standardized incidence rates (ASIRs) with and without adjustments for smoking prevalence rates, lung cancer, Canada, 1983–2032

[Click to enlarge]

[FIGURE 4.8.3, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.8.3
Age-standardized incidence rates (ASIRs) with and without adjustments for smoking prevalence rates, lung cancer, Canada, 1983-2032

Figure 4.8.3 shows the different results for projected lung cancer incidence in males and the similar results for females based on age-period-cohort models that include and exclude adjustment for available smoking prevalence data in Canada. The different reactions of the projection models to smoking factor for males and females are related to the different historical patterns of tobacco consumption and the lag of at least 20 years between a drop in smoking rates and subsequent decrease in cancer incidence rates. In the absence of incorporating smoking information into the model, we projected the current trend in a larger extent (model M1T) than the default gradual damping of the impact of the current trend in future periods (model M0T), on the assumption that the current trend will continue into the future. The projected lung cancer pattern in males follows the forecast derived from the default Nordpred drift reduction model (M0T) with adjustment for smoking.

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