Declining Lung Cancer Rates Among Young Men and Women in the United States: A Cohort Analysis
Abstract
Although overall age-adjusted rates of mortality from lung cancer in the United States continue to rise, rates at ages below 45 years have begun to decline. In this report we show that the decrease is greatest among white men, with a 29% drop between the mid-1970s and mid-1980s, but a decrease also occurred among black men and white and black women. Cohort analyses revealed that the rates of lung cancer peaked among men born around 1925-1930 and among women born around 1935-1940, and have declined thereafter. If these trends continue, overall lung cancer mortality rates will start to decline in the 1990s among men and after the year 2000 among women.
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Findings from a cohort of a specific age group collected in the past might not apply to people currently in the same age group.
“For example, findings from a cohort of a specific age group collected in the past might not apply to people currently in the same age group.118”
From Strengthening the Reporting of Observational Studies in Epidemiology using Mendelian Randomisation (STROBE-MR): explanation and elaboration. (2021) · cites this paper as [118]
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Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21660 · Cited by 108,699 · see citing works
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Parkin, D. M., Bray, F. I., & Devesa, S. S. (2001) · European Journal of Cancer · doi:10.1016/s0959-8049(01)00267-2 · Cited by 2,169 · see citing works
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BackgroundSelf-citationSkrivankova, V. W., Richmond, R. C., Woolf, B. A. R., Davies, N. M., Swanson, S. A., VanderWeele, T. J., Timpson, N. J., Higgins, J. P. T., Dimou, N., Langenberg, C., et al. (2021) · BMJ · doi:10.1136/bmj.n2233 · Cited by 1,648 · see citing works
Alberg, A. J., & Samet, J. M. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-4710-0.00046-8 · Cited by 1,060 · see citing works
Jemal, A., Thun, M. J., Ries, L. A. G., Howe, H. L., Weir, H. K., Ward, E., Wu, X., Eheman, C. R., Anderson, R. N., Ajani, U. A., et al. (2008) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djn389 · Cited by 946 · see citing works
Edwards, B. K., Brown, M. L., Wingo, P. A., Howe, H. L., Ward, E., Ries, L. A. G., Schrag, D., Jamison, P. M., Jemal, A., Wu, X. C., et al. (2005) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/dji289 · Cited by 952 · see citing works
Alberg, A. J., Brock, M. V., & Samet, J. M. (2003) · Elsevier eBooks · doi:10.1016/b978-1-4557-3383-5.00052-x · Cited by 784 · see citing works
Devesa, S. S., Bray, F., Vizcaino, A. P., & Parkin, D. M. (2005) · International Journal of Cancer · doi:10.1002/ijc.21183 · Cited by 746 · see citing works
Self-citationIncidence of Adenocarcinoma of the Esophagus Among White Americans by Sex, Stage, and Age
Brown, L. M., Devesa, S. S., & Chow, W.-H. (2008) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djn211 · Cited by 691 · see citing works
Self-citationSkin cancer. Melanoma and other specific nonmelanoma skin cancers
Elder, D. E. (1995) · Cancer · doi:10.1002/1097-0142(19950101)75:1+ · Cited by 103 · see citing works
Self-citationSmoking prevalence in US birth cohorts: the influence of gender and education.
Escobedo, L. G., & Peddicord, J. P. (1996) · American Journal of Public Health · doi:10.2105/ajph.86.2.231 · Cited by 281 · see citing works
Smoking and lung cancer: scientific challenges and opportunities.
Wynder, E. L., & Hoffmann, D. (1994) · PubMed · Cited by 267 · see citing works
Nonmelanoma skin carcinoma in Albuquerque, New Mexico: Experience of a major health care provider
Hoy, W. E. (1996) · Cancer · doi:10.1002/(sici)1097-0142(19960615)77:12 · Cited by 62 · see citing works
Self-citationLung Cancer—Where Are We Today?: Current Advances in Staging and Nonsurgical Treatment
Spiro, S. G., & Porter, J. C. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200202-070so · Cited by 251 · see citing works
Excess mortality among cigarette smokers: changes in a 20-year interval.
Thun, M. J., Day-Lally, C. A., Calle, E. E., Flanders, W. D., & Heath, C. W. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.9.1223 · Cited by 203 · see citing works
Davis, D. L., Hoel, D. G., Fox, J., et al. (1990) · The Lancet · doi:10.1016/0140-6736(90)92020-i · Cited by 202 · see citing works
Janssen-Heijnen, M. L. G., & Coebergh, J. W. W. (2001) · Lung Cancer · doi:10.1016/s0169-5002(00)00197-5 · Cited by 193 · see citing works
“In the USA, The Netherlands, Italy and Switzerland the highest rates were found for men born between 1910 and 1930 and women born after 1930 [16,17,19,20,26].”
BackgroundSmoking-attributable mortality and years of potential life lost — United States, 1988
SAM (1991) · Patient Education and Counseling · doi:10.1016/0738-3991(91)90081-f · Cited by 185 · see citing works
Recent Trends in Lung Cancer Mortality in the United States
Jemal, A., Chu, K. C., & Tarone, R. E. (2001) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/93.4.277 · Cited by 167 · see citing works
Osann, K. (1991) · PubMed · Cited by 163 · see citing works
Changing patterns of lung cancer incidence by histological type.
Devesa, S. S., Shaw, G., & Blot, W. J. (1993) · PubMed · Cited by 155 · see citing works
Self-citationPhysical activity and risk of lung cancer
Lee, I.-M. M., Sesso, H. D., & Paffenbarger, R. S. (1999) · International Journal of Epidemiology · doi:10.1093/ije/28.4.620 · Cited by 143 · see citing works
Diette, G. B., White, P., Terry, P. B., Jenckes, M. W., Rosenthal, D. L., & Rubin, H. R. (2000) · CHEST Journal · doi:10.1378/chest.117.4.1186 · Cited by 130 · see citing works
The changing pattern of lung carcinoma
Auerbach, O., & Garfinkel, L. (1991) · Cancer · doi:10.1002/1097-0142(19911101)68:9 · Cited by 168 · see citing works
Nitrite/ nitrate and cytokine levels in bronchoalvelar lavage fluid of lung cancer patients
Arias‐Díaz, J., Vara, E., Torres-Melero, J., Garcı́a, C., Baki, W., Ramσrez-Armengol, J. A., & Balibrea, J. L. (1994) · Cancer · doi:10.1002/1097-0142(19940901)74:5 · Cited by 73 · see citing works
Evans, W. E., Relling, M. V., Rahman, A., McLeod, H. L., Scott, E. P., & Lin, J. S. (1993) · Journal of Clinical Investigation · doi:10.1172/jci116441 · Cited by 109 · see citing works
Jemal, A., Travis, W. D., Tarone, R. E., Travis, L. B., & Devesa, S. S. (2003) · International Journal of Cancer · doi:10.1002/ijc.11020 · Cited by 100 · see citing works
Self-citationIncreasing Lung Cancer Death Rates Among Young Women in Southern and Midwestern States
Jemal, A., Ma, J., Rosenberg, P. S., Siegel, R. L., & Anderson, W. F. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2012.42.6098 · Cited by 97 · see citing works
“INTRODUCTION Lung cancer death rates in the United States decreased in successive younger birth cohorts after peaking among men and women born in the 1920s and 1930s, respectively.(1) However, the decreases abruptly slowed, particularly among women younger than age 50 years who were born circa the 1950s,(2-4) which te…”
Lung cancer and smoking trends in the United States over the past 25 years
Garfinkel, L., & Silverberg, E. (1991) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.41.3.137 · Cited by 93 · see citing works
Jemal, A., Cokkinides, V. E., Shafey, O., & Thun, M. J. (2003) · Cancer Causes & Control · doi:10.1023/a:1024891201329 · Cited by 84 · see citing works
“This is particularly true for lung cancer since the effect of decreasing the prevalence of smoking on lung cancer mortality was seen first in young adults in national vital statistics data from the US [25, 27, 29], UK [24, 29], and Australia [34].”
BackgroundThe epidemiology of lung cancer in women
Ernster, V. L. (1994) · Annals of Epidemiology · doi:10.1016/1047-2797(94)90054-x · Cited by 61 · see citing works
Postmenopausal Acceleration of Age-Related Mortality Increase
Horiuchi, S. (1997) · The Journals of Gerontology Series A · doi:10.1093/gerona/52a.1.b78 · Cited by 55 · see citing works
“This seems to merit attention, since considerable cohort variations are observed for smoking-related cancer mortality (Case, 1956; Devesa et al., 1989), and smoking is an important behavioral factor of sex mortality difference (Waldron, 1986).”
BackgroundTime trend and age-period-cohort effects on incidence of esophageal cancer in Connecticut, 1935?89
Zheng, T., Mayne, S. T., Holford, T. R., et al. (1992) · Cancer Causes & Control · doi:10.1007/bf00051361 · Cited by 50 · see citing works
Women and smoking: Current trends and issues for the 1990s
Berman, B. A., & Gritz, E. R. (1991) · Journal of Substance Abuse · doi:10.1016/s0899-3289(05)80038-0 · Cited by 46 · see citing works
Lung Cancer Risk among Exsmokers
Sobue, T., Suzuki, T., Fujimoto, I., et al. (1991) · Japanese Journal of Cancer Research · doi:10.1111/j.1349-7006.1991.tb01842.x · Cited by 43 · see citing works
The Convergence of Lung Cancer Rates between Blacks and Whites under the Age of 40, United States
Jemal, A., & Ward, E. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-09-0740 · Cited by 41 · see citing works
“Although lung cancer rates under the age of 40 are low, lung cancer rates in young adults provide an early indicator of generational changes in smoking prevalence and lung cancer rates and trends in the future (1, 28, 29).”
BackgroundA bibliography and comments on the use of statistical models in epidemiology in the 1980s
Gail, M. H. (1991) · Statistics in Medicine · doi:10.1002/sim.4780101204 · Cited by 33 · see citing works
Davis, D. L., Hoel, D. G., Fox, J., et al. (1990) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1990.tb32055.x · Cited by 33 · see citing works
Present and Past Smoking History and Other Predisposing Factors in 100 Lung Cancer Patients
Sridhar, K. S., & Raub, W. A. (1992) · CHEST Journal · doi:10.1378/chest.101.1.19 · Cited by 32 · see citing works
Incidence and prevalence of all cancerous diseases in Italy
Verdecchia, A., Mariotto, A. B., Capocaccia, R., et al. (2001) · European Journal of Cancer · doi:10.1016/s0959-8049(01)00094-6 · Cited by 30 · see citing works
Lung Cancer Not Attributable to Smoking
Axelson, O., Davis, D. L., Forestiere, F., et al. (1990) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1990.tb32065.x · Cited by 28 · see citing works
Cancer Incidence, Mortality, and Patient Survival in the United States
Ries, L. A. G., & Devesa, S. S. (2006) · doi:10.1093/acprof:oso/9780195149616.003.0009 · Cited by 26 · see citing works
Self-citationLung cancer mortality rates in birth cohorts in the United States from 1960 to 1994
Mannino, D. M., Ford, E. S., Giovino, G. A., & Thun, M. J. (2001) · Lung Cancer · doi:10.1016/s0169-5002(00)00170-7 · Cited by 25 · see citing works
“Age-specific lung cancer mortality rates have decreased in younger age groups in recent years [8].”
BackgroundParaneoplastic digital clubbing and hypertrophic osteoarthropathy
Benedek, T. G. (1993) · Clinics in Dermatology · doi:10.1016/0738-081x(93)90082-n · Cited by 24 · see citing works
Cohort Trends in Mortality from Oral, Esophageal, and Laryngeal Cancers in the United States
Devesa, S. S., Blot, W. J., & Fraumeni, J. F. (1990) · Epidemiology · doi:10.1097/00001648-199003000-00006 · Cited by 24 · see citing works
Self-citationPomerleau, C. S., Berman, B. A., Gritz, E. R., Marks, J. L., & Goeters, S. (1994) · Humana Press eBooks · doi:10.1007/978-1-4612-0299-8_2 · Cited by 23 · see citing works
Time trend in the surgical management of patients with lung carcinoma1
de Perrot, M. E., Licker, M. J., Robert, J. H., et al. (1999) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(99)00026-3 · Cited by 22 · see citing works
Lung Cancer in the Course of COPD-Emerging Problems Today
Ulińśki, R., Kwiecień, I., & Domagala-Kulawik, J. J. (2022) · Cancers · doi:10.3390/cancers14153819 · Cited by 22 · see citing works
“In North America and several European countries, incidence rates among women are still increasing, approaching or equalling those among men, while among men they are stable or slightly decreasing, especially in younger generations [6,7].”
BackgroundProjected numbers of cancers diagnosed in the US elderly population, 1990 through 2030.
Polednak, A. P. (1994) · American Journal of Public Health · doi:10.2105/ajph.84.8.1313 · Cited by 21 · see citing works
Riggs, J. E. (1991) · Mechanisms of Ageing and Development · doi:10.1016/0047-6374(91)90075-b · Cited by 19 · see citing works
Trends in lung cancer incidence in Sweden with special reference to period and birth cohorts
Mýrdal, G., Lambe, M. P., Bergström, R., et al. (2001) · Cancer Causes & Control · doi:10.1023/a:1011238525498 · Cited by 17 · see citing works
Higher lung cancer rates in young women than young men: Tasmania, 1983 to 1992
Dwyer, T., Blizzard, L., Shugg, D., et al. (1994) · Cancer Causes & Control · doi:10.1007/bf01804986 · Cited by 17 · see citing works
Hammar, S. P. (1994) · Springer eBooks · doi:10.1007/978-1-4757-3935-0_32 · Cited by 16 · see citing works
Recent Developments in the Treatment of Lung Cancer
Lin, A. Y. (1992) · JAMA · doi:10.1001/jama.1992.03480120099040 · Cited by 15 · see citing works
Lung Cancer and Smoking Trends in the United States Over the Past 25 Years
Garfinkel, L., & Silverberg, E. (1990) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1990.tb32063.x · Cited by 13 · see citing works
The regulation of tobacco and tobacco smoke
Gray, N. J., & Boyle, P. (2000) · Annals of Oncology · doi:10.1023/a:1008313631233 · Cited by 12 · see citing works
Prostate cancer mortality in the United States by cohort year of birth, 1865-1940.
Hsing, A. W., & Devesa, S. S. (1995) · PubMed · Cited by 11 · see citing works
Self-citationNonomura, A., Mizukami, Y., Shimizu, J., et al. (1995) · Journal of Surgical Oncology · doi:10.1002/jso.2930580103 · Cited by 10 · see citing works
Cancer patterns among women in the united states
Devesa, S. S. (1995) · Seminars in Oncology Nursing · doi:10.1016/s0749-2081(05)80015-4 · Cited by 9 · see citing works
Self-citationSerological tumor markers for small cell lung cancer and their therapeutic implications
Vangsted, A. J. (1994) · Apmis · doi:10.1111/j.1699-0463.1994.tb05206.x · Cited by 5 · see citing works
SMOKING CARCINOGENS AND LUNG CANCER – A REVIEW
S, V., Dharmashekara, C., Prasad, A., PRASAD, K. S., Srinivasa, C., Kavitha, G., Setty, P. B. S., & Shivamallu, C. (2021) · Asian Journal of Pharmaceutical and Clinical Research · doi:10.22159/ajpcr.2021.v14i1.39811 · Cited by 5 · see citing works
Testing for association in genetic studies
Laird, N. M., Kraft, P. L., Lange, C., & Steen, K. V. (2005) · CRC Press eBooks · doi:10.1201/b13341-5 · Cited by 4 · see citing works
Modal lifespan and disparity at older ages by leading causes of death: a Canada-U.S. comparison
Diaconu, V., Ouellette, N., & Bourbeau, R. R. (2020) · Journal of Population Research · doi:10.1007/s12546-020-09247-9 · Cited by 4 · see citing works
Hammar, S. P. (1995) · Springer eBooks · doi:10.1007/978-1-4612-2496-9_1 · Cited by 4 · see citing works
Franklin, R. A. (1992) · Nursing Clinics of North America · doi:10.1016/s0029-6465(22)02792-x · Cited by 4 · see citing works
Navigating Lung Cancer: Exploring Progress and Obstacles - A Comprehensive Review
Dorochowicz, M., Krzemienowska-Cebulla, A., Matus, I., Senat, H., & Madej, A. (2024) · Journal of Education Health and Sport · doi:10.12775/jehs.2024.61.006 · Cited by 3 · see citing works
“The reduction in lung cancer rates occurred several decades after the peak of smoking prevalence and was initially noticed in younger birth cohorts (19).”
BackgroundPopulation-Level Change in Risk Factors for Cancer
Colditz, G. A., Frazier, A. L., & Sorensen, G. (2005) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-47523-5_25 · Cited by 3 · see citing works
Bayesian Age-Period-Cohort Model of Lung Cancer Mortality
Tharu, B., Kafle, R. C., & Tsokos, C. P. (2022) · Epidemiology Biostatistics and Public Health · doi:10.2427/11444 · Cited by 2 · see citing works
“A decreasing mortality trend was observed during cohorts 1926-1951 which was attributed to the prevalence of smoking filter cigarettes and manufacture of low-tar cigarettes [25].”
BackgroundInfluentialMonitoring the Burden of Cancer in the United States
Howlader, N., Altekruse, S. F., & Edwards, B. K. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-627-6_1 · Cited by 2 · see citing works
Cancer: Global Burden/Trends and Projections
Bray, F. (2008) · Elsevier eBooks · doi:10.1016/b978-012373960-5.00265-3 · Cited by 2 · see citing works
The slowing of the lung cancer epidemic and the need for continued vigilance
Novello, A. C., Davis, R. M., & Giovino, G. A. (1991) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.41.3.133 · Cited by 2 · see citing works
CANCER SURVEILLANCE SERIES Recent Trends in Lung Cancer Mortality in the United States
Jemal, A., Chu, K. C., & Tarone, R. E. (2001) · Cited by 2 · see citing works
Rosenberg, P. S. (2015) · Wiley StatsRef: Statistics Reference Online · doi:10.1002/9781118445112.stat05266.pub2 · Cited by 2 · see citing works
Study of age specific lung cancer mortality trends in the US using functional data analysis
Tharu, B., Pokhrel, K., Aryal, G., et al. (2021) · Communications for Statistical Applications and Methods · doi:10.29220/csam.2021.28.2.119 · Cited by 1 · see citing works
“…rates for the age group below 30 for males and females are likely to be stable (John and Hanke, 2016) in the future because of advanced treatments and early detection (Devesa et al., 1989; Rapp et al., 1988; Corrales et al., 2018; Antonia et al., 2014) as well as strong body functionality.”
BackgroundUS and Global Epidemiology and Incidence Rates of Lung Cancer
DeBiasi, E. M. (2023) · Respiratory medicine · doi:10.1007/978-3-031-38412-7_1 · Cited by 1 · see citing works
The incidence of lung cancer in Northern Ireland: 1991–1992
Wilkinson, P., MacMahon, J., & MacKenzie, G. (2021) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-021-02783-0 · Cited by 1 · see citing works
Epidemiology of Lung Cancer in Women
Wu, A. H., & Seow, A. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-384978-6.00079-0 · Cited by 1 · see citing works
Testing for association in genetic studies
Laird, N. M., Kraft, P., Lange, C., et al. (2005) · CRC Press eBooks · doi:10.1201/b13341-20 · Cited by 1 · see citing works
Epidemiology of Lung Cancer in Women
Wu, A. H. (2000) · Elsevier eBooks · doi:10.1016/b978-012288145-9/50086-3 · Cited by 1 · see citing works
Anti-tobacco measures in the world: the French case
Hirsch, A., & Slama, K. (1992) · Tubercle and Lung Disease · doi:10.1016/0962-8479(92)90083-v
Progress and challenges in the global effort against cancer
Broder, S. E. (1991) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/bf01630710
“The efforts in women and in some minorities are just starting to gain ground (Devesa et al. 1989).”
BackgroundA Decline in the Lung Cancer Incidence Amongst Men in Swedish Cities
Wersäll, P. J., Barlow, L., & EKLUND, G. A. (1996) · Acta Oncologica · doi:10.3109/02841869609109911
Chapter 10-Current and Future Perspectives
Rose, S. (1994) · doi:10.1520/mnl10148m
Statistical Analysis and Modeling Health Data: A Longitudinal Study
Tharu, B. (2016) · Digital Commons - University of South Florida (University of South Florida)
Rosenberg, P. S. (2014) · Wiley StatsRef: Statistics Reference Online · doi:10.1002/9781118445112.stat05266
Rosenberg, P. S. (2005) · Encyclopedia of Biostatistics · doi:10.1002/0470011815.b2a07013
- Authors
- Devesa, S. S., Blot, W. J., & Fraumeni, J. F.
- Affiliations
- National Cancer Institute (US)
- Corresponding author
- Devesa, S. S.
- Venue
- JNCI Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 1989-10-18
- Volume
- 81
- Issue
- 20
- Pages
- 1568-1571
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- OpenAlex
- W2171191579
- Cited by
- 86
- References
- 0
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2012: 2
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JNCI Journal of the National Cancer Institute (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- lung cancer mortality, mortality decline, young adults, cohort analysis, age-adjusted mortality rates, racial differences, white men, Black men, women, birth cohort, United States
- MeSH terms
- Adult, Age Factors, Aged, Female, Humans, Lung Neoplasms, Male, Middle Aged, Smoking, United States, Cohort Studies
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